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Deep Brain Stimulation and Cognitive Outcomes Among Patients With Parkinson's Disease: A Historical Cohort Study
Allison L Hansen1, Janina Krell-Roesch1, Kristin A Kirlin1
1The Translational Neuroscience and Aging Laboratory, Mayo Clinic, Phoenix, Ariz. (Krell-Roesch, Velgos, Geda); the Department of Psychiatry and Psychology, Mayo Clinic, Phoenix, Ariz. (Kirlin, Geda); the Department of Neurological Surgery, Phoenix, Ariz. (Lyons); and the Department of Neurology, Mayo Clinic, Phoenix, Ariz. (Geda, Mehta).
Objective:
Deep brain stimulation (DBS) is an effective treatment for motor symptoms of Parkinson's disease; however, there is conflicting literature about the effect of DBS on cognitive function. The authors conducted a historical cohort study involving patients with Parkinson's disease who underwent DBS of the globus pallidus pars interna (GPi; N=12) or subthalamic nucleus (STN; N=17).
Methods:
The authors investigated differences in four neuropsychological test scores at 6 months post-DBS (follow-up) as compared with baseline (i.e., Boston Naming Test, WAIS Verbal Comprehension Index [WAIS-VCI], Working Memory Index [WAIS-WMI], and Processing Speed Index [WAIS-PSI]).
Results:
GPi DBS patients showed no difference between baseline and follow-up on any neuropsychological test. STN DBS patients had lower scores indicating decreased performance at follow-up as compared with baseline on WAIS-PSI (mean [SD], 91.47 [10.42] versus 81.65 [12.03]; p=0.03). There was a significant (p=0.008) difference between the change in baseline to follow-up scores on the WAIS-VCI for the STN DBS and GPi DBS groups (i.e., STN DBS patients scored lower at the 6-month follow-up compared with baseline, whereas GPi DBS patients scored higher).
Conclusions:
GPi may be a preferred target for DBS in patients with Parkinson's disease when considering cognitive outcomes.