Details

Autor(en) / Beteiligte

• Mulders, Anne E.P.
• Temel, Yasin
• Tonge, Mehmet
• Schaper, Frédéric L.W.V.J.
• van Kranen-Mastenbroek, Vivianne
• Ackermans, Linda
• Kubben, Pieter
• Janssen, Marcus L.F.
• Duits, Annelien

Titel

The association between surgical characteristics and cognitive decline following deep brain stimulation of the subthalamic nucleus in Parkinson’s disease

Ist Teil von

• Clinical neurology and neurosurgery, 2021-01, Vol.200, p.106341-106341, Article 106341

Ort / Verlag

Netherlands: Elsevier B.V

Erscheinungsjahr

2021

Link zum Volltext

Quelle

Elsevier ScienceDirect Journals

Beschreibungen/Notizen

• •MER is typically used to optimize lead implantation during STN-DBS in Parkinson’s disease.•Nr of MER trajectories used during STN-DBS was not associated with cognitive decline.•Length of the final DBS trajectory in the STN was not associated with cognitive decline.•Electrode passage through the right prefrontal lobe may contribute to executive function changes.•From a cognitive point of view, DBS in PD may be considered a relatively safe procedure. Despite optimal improvement in motor functioning, both short- and long-term studies have reported small but consistent changes in cognitive functioning following STN-DBS in Parkinson’s disease (PD). The aim of the present study was to explore whether surgical characteristics were associated with cognitive decline one year following STN-DBS. We retrospectively analyzed 49 PD patients who underwent bilateral STN-DBS. Cognitive change scores were related to the number of microelectrode recording (MER) trajectories, the STN length as measured by MER, and cortical entry points. Regression analyses were corrected for age at surgery, disease duration, education and preoperative levodopa responsiveness. Patients were then divided into a cognitive and non-cognitive decline group for each neuropsychological test and compared regarding demographic and surgical characteristics. One year postoperatively, significant declines were found in verbal fluency, Stroop Color-Word test and Trail Making Test B (TMT-B). Only changes in TMT-B were associated with the coronal entry point in the right hemisphere. The number of MER trajectories and STN length were not associated with cognitive change scores. When comparing the cognitive decline and non-cognitive decline groups, no significant differences were found in surgical characteristics. The electrode passage through the right prefrontal lobe may contribute to subtle changes in executive function. However, only few patients showed clinically relevant cognitive decline. The use of multiple MER trajectories and a longer STN length were not associated with cognitive decline one year following surgery. From a cognitive point of view, DBS may be considered a relatively safe procedure.