Abstract Details

Title Smoking History Correlates with Worsened Motor and Cognitive Outcomes Following DBS in Parkinson’s Disease

Topic Movement Disorders

Presentation(s) P2 - Poster Session 2 (8:00 AM-9:00 AM)

Poster/Presentation
Number 5-022

Objective Evaluate the effects of cigarette use on post-surgical outcomes in Parkinson’s Disease (PD) patients following Deep Brain Stimulation (DBS) surgery to aid in risk stratification.

Background

The impact of smoking on DBS outcomes has scarcely been studied. Smoking is linked to a lower risk of PD and reduced PD-related mortality, although cognitive decline and smoking-related cancers attenuate these benefits. Investigating smoking's effects on post-DBS outcomes may help inform surgical candidacy.

Design/Methods Fifty-four PD-DBS patients (M_{age_at_DBS}=66.1, 14 females, M_{disease_duration}=9.8 years) underwent pre- and post-DBS (83% Bilateral, 81% Subthalamic nucleus) neuropsychological evaluations. Neuropsychological data on executive function, attention, language, memory, and visuospatial abilities were standardized. UPDRS scores and Levodopa Equivalent Daily Dose were analyzed. Smoking history (25 smokers, range=1-48 pack-years) was extracted from records. Logistic and linear regressions assessed correlations between smoking and post-DBS motor, medication, and neuropsychological outcomes, adjusting for age, disease duration, education, and sex. Changes in UPDRS and neuropsychological domains were the primary outcomes.

Results

Years smoking correlated with increased ΔUPDRS (worsening) scores post-DBS, with each additional year correlating to a 0.23-point increase (p=0.019). Pack-years were associated with a decreased likelihood of motor improvement compared to remaining stable after surgery (p=0.022). Pack-years (p=0.018) and female sex (p=0.034) were associated with worsened visuospatial function, and female sex also correlated with worsened attention (p=0.017). No correlations were identified in language, memory, or executive function.

Conclusions Smoking history was linked to worsened motor and visuospatial outcomes post-DBS. Sex differences were noted in cognitive outcomes. These negative effects may be mediated by vascular pathologies, warranting further study into the mechanism behind this relationship. Comorbidities like hypertension and diabetes were not accounted for in this study, and doing so will be the next immediate step. Further research is also needed to explore the relationship between smoking, post-surgical complications, and outcomes.

Authors/Disclosures
Aidan T. Kunju (University of Miami Miller School of Medicine) PRESENTER	Mr. Kunju has nothing to disclose.
Jessica Herman	Ms. Herman has nothing to disclose.
Marina Sarno, Other (University of Miami Department of Neurology)	Dr. Sarno has nothing to disclose.
Scott Harcourt, PhD (Blue Cat Neuropsychology & Intervention, PLLC)	Dr. Harcourt has nothing to disclose.
Jonathan Jagid	Jonathan Jagid has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Miami Dade County State Attorneys office. The institution of Jonathan Jagid has received research support from Boston Scientific.
Corneliu C. Luca, MD (University of Miami)	Dr. Luca has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Boston Scientific. Dr. Luca has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Signant Health. Dr. Luca has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Abbott.
Matthew Feldman, MD	Dr. Feldman has nothing to disclose.
Ihtsham Haq, MD, FAAN (University of Miami Miller School of Medicine)	The institution of Dr. Haq has received research support from NINDS. The institution of Dr. Haq has received research support from the Parkinson's Foundation.

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