1. Predictors of multi-domain cognitive decline following DBS for treatment of Parkinson's disease
- Author
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Johannes C. Rothlind, Michele K. York, Ping Luo, Kim Carlson, William J. Marks, Frances M. Weaver, Matthew Stern, Kenneth A. Follett, John E. Duda, Domenic J. Reda, Kenneth Follett, Frances Weaver, Dolores Ippolito, Gatana Stoner, Tammy Barnett, Ken Bukowski, Rosemarie DeNicolo, Kwan Hur, Joyce Jimenez, Jan Motyka, Domenic Reda, Theresa Simon, Bharat Thakkar, Robert Woolson, Carol Fye, William Gagne, Crystal Harris, Jill Heemskerk, Claudia Moy, Paul Sheehy, Timothy O'Leary, Grant D. Huang, Louis Fiore, Robert Hall, Kevin Stroupe, Kim Burchiel, William Koller, Rajesh Pahwa, Johannes Rothlind, Oren Sagher, Roy Bakay, Rick Chappell, Robert Hart, Robert Holloway, George McCabe, Margaret Schenkman, Jamal Taha, Julia Buckelew, Marilyn Garin, Sharon Matzek, Donna Smith, Jeff Bronstein, John Duda, Penelope Hogarth, Kathryn Holloway, Stacy Horn, Eugene C. Lai, Ali Samii, null Farah Atassi, Cecilia Bello, Lisette Bunting-Perry, Tina Conn, Alice Cugley, Nanette Eubank, Linda Fincher, Romay Franks, Tammy Harris, Mariann Haselman, Susan Heath, Miriam Hirsch, Virginia Janovsky, Elaine Lanier, Mary Lloyd, Susan Loehner, Susan O'Connor, Ligaya Ordonez, Heather Maccarone, Kelli Massey-Makhoul, Mary Matthews, Elizabeth Meyn, Keiko Mimura, Wes Morrow, Tammy Searles, Jamye Valotta, Usha Vasthare, Monica Volz, Constance Ward, Rebecca Warker, Heidi Watson, Pamela Willson, Mark Baron, Matthew Brodsky, Vincent Calabrese, Gordon Campbell, Amy Colcher, Emad Farag, Eva Henry, Jyh-Gong Hou, Gail Kang, Galit Kleiner-Fisman, Jeff Kraakevik, John Nutt, Jill Ostrem, Aliya Sarwar, Indu Subramanian, Zeba Vanek, Gordon Baltuch, Antonio De Salles, Jorge Eller, Paul Larson, Richard Simpson, Philip Starr, William Carne, Tom Erikson, Jeffrey Kreutzer, Mario Mendez, Paul Moberg, John Ragland, Ronald Seel, Daniel Storzbach, Alexander Troster, Michele York, and Jurg Jaggi
- Subjects
Neurology ,Subthalamic Nucleus ,Deep Brain Stimulation ,Humans ,Cognitive Dysfunction ,Parkinson Disease ,Neurology (clinical) ,Neuropsychological Tests ,Geriatrics and Gerontology ,Aged - Abstract
Statistically and clinically significant cognitive declines are observed in a small subset of individuals with Parkinson's Disease (PD) following treatment with Deep Brain Stimulation (DBS).We examine the association between multi-domain cognitive decline (MCD) and demographic and baseline clinical variables and the incidence of serious adverse events (SAE) arising within a six-month interval following DBS for PD.Study participants with PD who displayed MCD at 6-month follow-up evaluation after DBS (n = 18) were contrasted with individuals with PD from the same study who did not show cognitive decline after DBS (n = 146). Logistic regression analyses were employed to assess relationship between predictors, including age (70 years old), pre-DBS cognitive screening test performance, SAE, and MCD. MCD+ and MCD-groups were also compared on other baseline clinical and demographic variables.MCD showed modest association with older age and lower baseline neurocognitive screening performance, whereas the groups did not differ on most other baseline clinical and demographic variables. SAEs during the study interval were the most robust predictor of MCD in the DBS group. A variety of SAEs were documented in study participants experiencing MCD after DBS surgery, including, but not limited to, infections and small intracranial hemorrhages.Older age and lower baseline cognition measured prior to treatment are associated with MCD measured at six-months after DBS. SAE occurring following DBS surgery are also predictive of MCD. These predictors may reflect aspects of "frailty" in advanced PD. Risk factors for SAE warrant careful consideration in clinical trials.
- Published
- 2022