Initial cognitive dip after subthalamic deep brain stimulation in Parkinson disease

Area of Science:

• Neuroscience
• Neurology
• Neurosurgery

Background:

• Subthalamic nucleus deep brain stimulation (STN DBS) is a common treatment for Parkinson disease (PD).
• While generally considered safe cognitively, some studies report cognitive decline after STN DBS, particularly in the early post-operative period.

Purpose of the Study:

• To compare the rate of global cognitive function change in the first 6 months after STN DBS with the change between 6 and 36 months post-surgery.
• To identify factors associated with early cognitive decline following STN DBS in PD patients.

Main Methods:

• A cohort of 36 Parkinson disease patients undergoing bilateral STN DBS with over 3 years of follow-up was analyzed.
• Mini-Mental Status Examination (MMSE) scores were compared between the first 6 months and the 6- to 36-month interval post-surgery.

Main Results:

• Global cognitive function, measured by MMSE, declined significantly faster during the initial 6 months after STN DBS compared to the period between 6 and 36 months.
• Baseline levodopa equivalent daily dose and Stroop Color-word test scores were significantly associated with the rate of MMSE decline within the first 6 months.

Conclusions:

• Global cognitive function decline in Parkinson disease patients undergoing STN DBS is most pronounced within the first 6 months after surgery.
• Early cognitive changes after STN DBS warrant close monitoring, with baseline factors potentially predicting the rate of decline.