Log In

Forgot Password?
Create New Account

Loading... please wait

Abstract Details

Are there predictors of neuropsychological cognitive decline in Parkinson’s Disease patients who have undergone Deep Brain Stimulation Surgery?
Movement Disorders
P6 - Poster Session 6 (5:30 PM-6:30 PM)
5-016

Pre- and post- operative neuropsychological assessments identify pre-existing cognitive deficits and determine cognitive outcome amongst PD-DBS patients. Post-operative cognitive decline is not well-defined and contributing factors are not well-understood. Declining performance on LM-Delayed Recall (LMDR) indicates memory loss and cognitive decline in PD.


To identify determinants of post-Deep Brain Stimulation (DBS) cognitive decline in individuals with Parkinson’s Disease (PD). 




We retrospectively reviewed PD-DBS patients who completed DBS workup, surgery and 1-year post-operative neuropsychology testing at a single center between 2015-2022.  Reliable Change Indices (RCI) and Z-scores identified individual clinically significant differences in neurocognitive performance from pre- to post- DBS exams [WMS-IV Logical Memory (LM), HVLT-R, WASI-II].  Patients with clinically significant declining performance on LMDR were identified, yielding groups with and without post-operative cognitive decline. Between-group comparisons of disease features (e.g., duration, L-Dopa burden, DBS target), socio-demographic background, presence of imaging abnormalities (pre- and post- DBS), assessment modality (telehealth vs in-office), and cognitive diagnosis (amnestic vs non-amnestic MCI), were made using t-tests, chi square, and regression analyses.


62 subjects completed pre- and post-DBS neuropsychological testing. N=18 were excluded (n=8 without PD, n=3 non-English speakers, 7 without pre- and post- WMS-IV testing). Amongst 44 included subjects, there was statistically significant decline in FAS and Animals trials (p <.001, p < .001). N=8 (18%) declined on >1 neurocognitive trials, including LMDR. Between groups with and without cognitive decline, there were no additional significant differences in the assessed baseline variables. N=5 (14%) in the cognitively stable group vs. n=6 (75%) in the cognitively worsened group had postoperative imaging abnormalities (p=0.013) with either edema or hemorrhage.

18% of PD-DBS patients declined cognitively after surgery. Despite exploring features at both the group and individual levels, no predictors were found, whereas peri- or post-operative factors may contribute.


Authors/Disclosures
Joohi Jimenez Shahed, MD (Icahn School of Medicine at Mount Sinai)
PRESENTER
Dr. Jimenez Shahed has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Bracket Global LLC. Dr. Jimenez Shahed has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Teva. Dr. Jimenez Shahed has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Medtronic. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alpha Omega. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Consultant for RegenXBio. Dr. Jimenez Shahed has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Praxis. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Kyowa Kirin. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amneal. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BlueRock Therapeutics. Dr. Jimenez Shahed has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for PhotoPharmics. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Emalex. The institution of Dr. Jimenez Shahed has received research support from Michael J Fox Foundation. The institution of Dr. Jimenez Shahed has received research support from Amneal. The institution of Dr. Jimenez Shahed has received research support from Annovis. The institution of Dr. Jimenez Shahed has received research support from SAGE. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Faculty with Movement Disorders Society. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Faculty with American Academy of Neurology. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Grant Reviewer with Parkinson Foundation. Dr. Jimenez Shahed has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant on Research Grant with Florida Atlantic University. Dr. Jimenez Shahed has received personal compensation in the range of $0-$499 for serving as a Speaker with Tourette Association of America. Dr. Jimenez Shahed has received personal compensation in the range of $5,000-$9,999 for serving as a Speaker with NACCME.
No disclosure on file
No disclosure on file
Christina Palmese No disclosure on file