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Abstract Details

The Influence of DBS Decision-Making on Long-term Neuropsychological Outcomes Following DBS Placement in PD
Movement Disorders
P1 - Poster Session 1 (8:00 AM-9:00 AM)
17-005

To assess the influence of surgical variables, including deep brain stimulation (DBS) target (STN vs GPi) and sidedness (unilateral vs bilateral), on neuropsychological and functional outcomes in Parkinson’s disease (PD) patients one year following deep brain stimulation.

Although motor benefits from DBS in a PD population are well-evidenced, nonmotor outcomes following surgery vary. Limited long-term neuropsychological data exist to assess the effect of certain surgical variables. Understanding the effect of target or laterality of implantation may be useful in terms of patient selection and counseling.
A cohort of n=61 PD patients undergoing DBS was analyzed. Average age was 68.6, average disease duration 10.32 years. Average OFF UPDRS part III was 42.4, ON 16.6 at time of presurgical evaluation. Patients underwent neuropsychological testing pre- and 12-months post-operatively, including change in Katz Index of Activities of Daily Living (ADL), Parkinson’s Disease Questionnaire-39 (PDQ-39), Apathy Evaluation Scale (AES), verbal fluency scoring (PTM), and Beck Anxiety Inventory (BAI). Group differences were analyzed using paired t-tests controlling for baseline scores and demographics.
Significant between-group differences were apparent in multiple areas. GPi patients demonstrated greater decline in PDQ-39 Social Support (-1.67 vs. 1.89, p=0.02) and Katz ADL (-1.00 vs. 4.72, p=0.03) compared with STN. Patients with bilateral implantation showed less improvement in the PTM than unilaterally implanted patients (00.36 vs. 2.5, p=0.02) and more decline on the BAI (-4.32 vs. 1.29, t=-0.04).
DBS target and sidedness each contribute uniquely to postoperative neuropsychological profiles. GPi patients showed greater average decline in measures of both self-sufficiency and social support than STN patients. Patients implanted bilaterally showed poorer outcomes in measures of fluency and anxiety, adding to established data that verbal fluency typically declines more prominently following bilateral DBS. These findings underscore the need to consider surgical parameters when counseling patients and interpreting cognitive and affective outcomes after DBS.
Authors/Disclosures
Aidan T. Kunju (University of Miami Miller School of Medicine)
PRESENTER 		Mr. Kunju has nothing to disclose.
Benjamin Coleman The institution of Mr. Coleman has received research support from 好色先生.
Tara Najafi Ms. Najafi has nothing to disclose.
Allan George Mr. George has nothing to disclose.
Jamie Harris, BS Ms. Harris has nothing to disclose.
Jason H. Margolesky, MD, FAAN (University of Miami School of Medicine) Dr. Margolesky has nothing to disclose.
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.
Marina Sarno, Other (University of Miami Department of Neurology) Dr. Sarno has nothing to disclose.