Abstract Details

Title Cognitive Outcomes in Parkinson’s Disease Following Subthalamic Nucleus Deep Brain Stimulation: A Case Series of 32 Patients with Pre-operative and Post-operative Neuropsychological Evaluations

Topic Movement Disorders

Presentation(s) P10 - Poster Session 10 (8:00 AM-9:00 AM)

Poster/Presentation
Number 17-001

Objective To identify baseline factors predictive of cognitive decline following STN DBS and understand cognitive outcomes in PD patients post-STN DBS using a comprehensive neuropsychological battery.

Background While subthalamic nucleus deep brain stimulation (STN-DBS) offers substantial motor benefit in Parkinson’s disease (PD), cognitive trajectories post-DBS remain variable and incompletely understood. Identifying preoperative predictors of post-operative cognitive decline may help to improve patient selection, counseling, and surgical outcomes.

Design/Methods A retrospective case series of 32 PD patients (6 females, 26 males; age range: 53–82 years) who underwent STN-DBS, with 3 patients receiving staged procedures. All patients completed standardized neuropsychological testing at baseline (pre-operatively) and at 1–3 years postoperatively. A comprehensive neuropsychological evaluation included assessment of attention/working memory, processing speed, visuospatial functioning, expressive language (including verbal fluency), memory, and executive functioning in addition to assessment of mood. At baseline, 9/32 exhibited normal cognitive performance, while the remainder showed mild cognitive impairment.

Results At 1-year follow-up, the majority of patients exhibited largely similar and stable cognitive performances relative to baseline. By 3 years post-DBS, a notable subset showed cognitive decline, particularly in executive function domains. Only 2 patients met clinical criteria for dementia. Cognitive decline was more frequently observed in older patients and those with pre-existing impairments. Importantly, cognitive stability was associated with better optimization of both motor and non-motor symptoms postoperatively.

Conclusions

1. Baseline cognitive status is a strong predictor of post-DBS cognitive trajectory.

2. Advanced age correlates with more cognitive decline post-DBS.

3. Effective management of both motor and non-motor symptoms post-DBS may prolong cognitive stability.

Authors/Disclosures
Lin Zhang, MD, PhD, FAAN (UCDMC) PRESENTER	Dr. Zhang has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for supernus. Dr. Zhang has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for supernus. The institution of Dr. Zhang has received research support from Michael J. Fox Foundation.
Meera Bedi, MD	Dr. Bedi has nothing to disclose.
Laura M. Sperry, RN, NP (UC Davis Health)	Ms. Sperry has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbott. Ms. Sperry has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Abbott.
Michelle Chan (UC Davis)	Michelle Chan has nothing to disclose.
Kandis Kaltenbach	Mrs. Kaltenbach has nothing to disclose.

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