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Pre-operative cognitive burden as predictor of motor outcome following bilateral subthalamic nucleus deep brain stimulation in Parkinson’s disease

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Abstract

Introduction

The interrelationship between neurocognitive impairments and motor functions was observed in patients with advanced Parkinson’s disease (PD). This study was conducted to identify pre-operative neurocognitive and clinical predictors of short-term motor outcome following subthalamic nucleus deep brain stimulation (STN-DBS).

Methods

All consecutive PD patients who were eligible for bilateral STN-DBS from 2009 to 2019 were evaluated before and at 1 year following surgery. Standard motor evaluation and neurocognitive tests including global cognition, memory, executive functions (attention and category fluency), confrontational speech, visuospatial abilities, and mood were conducted at baseline. The post-operative STN-DBS effects were assessed at 1 year following the surgery. Multiple regression analysis was applied to identify baseline independent predictors of post-operative STN-DBS effect.

Results

A total of 82 patients were analyzed. It was found that younger age at operation, higher levodopa responsiveness at baseline based on UPDRS-III total score, and better baseline verbal delayed memory and category fluency predicted post-operative motor outcome at 1 year following STN-DBS (F = 9.639, p < 0.001, R2 = .340).

Conclusion

Our findings demonstrated the role of baseline cognitive burden, especially cognitive processes related to frontostriatal circuits, was significant clinical predictors of short-term motor outcomes following STN-DBS. Profile analysis of neurocognitive functions at baseline is recommended.

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Authors and Affiliations

  1. Department of Clinical Psychology, Prince of Wales Hospital, Hospital Authority, Shatin, Hong Kong

    Venus Tang

  2. Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Chinese University of Hong Kong, Shatin, Hong Kong

    Venus Tang, Xian Lun Zhu, David Yuen Chung Chan, Danny Chan & Wai Sang Poon

  3. Margaret K.L. Cheung Research Centre for Management of Parkinsonism, Division of Neurology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong

    Claire Lau, Anne Chan, Karen Ma & Vincent Mok

  4. Department of Medicine, Alice Ho Miu Ling Nethersole Hospital, Hospital Authority, Tai Po, Hong Kong

    Jonas Yeung

  5. Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong

    Tom Cheung & Jill Abrigo

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  1. Venus Tang
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Correspondence to Venus Tang.

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Ethical approval

Ethical approval was obtained from the Hong Kong New Territories East Cluster Clinical Research Ethics Committee for the retrospective use of these clinical data. Written informed consent was obtained from each patient at pre-operation.

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Tang, V., Zhu, X.L., Lau, C. et al. Pre-operative cognitive burden as predictor of motor outcome following bilateral subthalamic nucleus deep brain stimulation in Parkinson’s disease. Neurol Sci 43, 6803–6811 (2022). https://doi.org/10.1007/s10072-022-06370-8

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  • DOI: https://doi.org/10.1007/s10072-022-06370-8

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