Abstract Details

Title Levodopa Response and Cognitive Function in Parkinson's Disease: An Analysis of Patients Evaluated for Deep Brain Stimulation

Topic Movement Disorders

Presentation(s) P9 - Poster Session 9 (11:45 AM-12:45 PM)

Poster/Presentation
Number 5-010

Objective To assess the association between levodopa response and cognitive function, measured by Montreal Cognitive Assessment (MoCA) and Dementia Rating Scale-2 (DRS-2), in patients with advanced Parkinson’s disease (PD).

Background Levodopa response (LR) supports the clinical diagnosis of PD and is used to predict motor outcomes following deep brain stimulation (DBS). However, the relationship between LR and cognitive performance remains unclear. Understanding this relationship may help with evaluating patient outcomes and treatment planning, particularly when considering advanced treatment options.

Design/Methods

We reviewed data from patients with PD evaluated for DBS, including OFF/ON levodopa motor scores and cognitive assessments (MoCA and/or DRS-2). Patients were grouped based on %LR: Low (<30%), Moderate (30-50%), and Good (>50%). Differences in MoCA and DRS-2 scores among groups were analyzed using the Kruskal-Wallis test with Dunn’s post-hoc comparisons. Spearman’s correlation assessed the relationship between %LR and cognitive measures, and generalized linear models (GLM) were used to adjust for age and disease duration.

Results

A total of 279 patients (mean age: 64.1 years, disease duration: 9.2 years) were included. Of these, 240 had MoCA scores (mean±SD: 25.8±3.4) and 203 had DRS-2 scores (mean±SD: 135.6± 6.2) available. MoCA scores were significantly different among groups (p=0.001), with the Good response group having higher scores compared to the Low (p=0.003) and Moderate (p=0.018) groups. DRS-2 scores showed no significant differences (p=0.231) across groups. There was a positive correlation between %LR and MoCA scores (rho=0.28, p<0.001), while %LR and DRS-2 scores showed no significant correlation. After adjusting for age and disease duration, GLM showed %LR was significantly associated with MoCA (p<0.001), while its effect on DRS-2 was smaller (p=0.041).

Conclusions

Levodopa response is associated with cognitive function, particularly as measured by MoCA. Further longitudinal studies may provide insights into whether motor response to levodopa can predict cognitive function over time.

Authors/Disclosures
Anjali M. Varghese, DO (Berkshire Medical District) PRESENTER	Dr. Varghese has nothing to disclose.
Umar Yazdani (UT SOUTHWESTERN MEDICAL CENTER)	Mr. Yazdani has nothing to disclose.
William Goette, PhD	The institution of Dr. Goette has received research support from Texas Alzheimer's Research and Care Consortium. The institution of Dr. Goette has received research support from National Institute of Aging.
Ann M. Gordon, PA	Ms. Gordon has nothing to disclose.
Frederick Hitti, MD, PhD	Dr. Hitti has nothing to disclose.
Shilpa Chitnis, MD, PhD, FANA, FAAN (UT Tyler School of Medicine)	Dr. Chitnis has received publishing royalties from a publication relating to health care.
Nader Pouratian, MD, PhD	Dr. Pouratian has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boston Scientific. Dr. Pouratian has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Abbott. Dr. Pouratian has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbott.
Laura Lacritz, PhD	Dr. Lacritz has received personal compensation for serving as an employee of University of Texas Southwestern Medical Center. Dr. Lacritz has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for Various.
Vibhash D. Sharma, MD, FAAN (University of Texas Southwestern Medical Center)	Dr. Sharma has nothing to disclose.

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