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Updated: Dec 16, 2025
Controlling Parkinson's Disease With Adaptive Deep Brain Stimulation
Published on: July 16, 2014
Dementia and subthalamic deep brain stimulation in Parkinson disease: A long-term overview
Francesco Bove1, Valerie Fraix1, Francesco Cavallieri1
1From the Movement Disorders Unit (F.B., V.F., F.C., E.S., E.L., A.B., S.M., P.P., A.K., E.C., C.A., P.K., A.C., E.M.) and Neurosurgery Department (A.L.B., S.C., E.S.), CHU Grenoble Alpes, France; Institute of Neurology (F.B.), Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Del Sacro Cuore, Rome, Italy; U1216 (V.F., E.S., E.L., A.B., S.M., P.P., A.K., E.C., C.A., P.K., A.L.B., S.C., E.S., A.C., E.M.), Grenoble Institut des Neurosciences, Inserm, Université Grenoble Alpes, France; Neurology Unit (F.C.), Neuromotor & Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia; Clinical and Experimental Medicine PhD Program (F.C.), University of Modena and Reggio Emilia, Modena; Department of Clinical and Movement Neurosciences (P.L.), University College London Queen Square Institute of Neurology, UK; and Department of Neurology (P.K.), INSELSPITAL, University Hospital Bern, Switzerland.
Objectives:
To assess the prevalence and the cumulative incidence of dementia at short-, medium- and long-term follow-up after deep brain stimulation (DBS) of the subthalamic nucleus (STN) (at 1, 5, and 10 years) and to evaluate potential risk factors for postoperative dementia.
Methods:
The presence of dementia (according to the DSM-V) was retrospectively evaluated at each postoperative follow-up in patients with Parkinson disease (PD) who underwent bilateral STN-DBS. Preoperative and perioperative risk factors of developing postoperative dementia were also investigated. Demographic data, disease features, medications, comorbidities, nonmotor symptoms, PD motor scales, neuropsychological scales at baseline, and perioperative complications were collected for each patient.
Results:
A total of 175 patients were included, and 104 were available at 10-year follow-up. Dementia prevalence was 2.3% at 1 year, 8.5% at 5 years, and 29.8% at 10 years. Dementia cumulative incidence at 1, 5, and 10 years was 2.3%, 10.9%, and 25.7%, respectively. The corresponding dementia incidence rate was 35.6 per 1,000 person-years. Male sex, higher age, hallucinations, lower frontal score at baseline, and perioperative cerebral hemorrhage were predictors of dementia.
Conclusions:
In patients with PD with longstanding STN-DBS, dementia prevalence and incidence are not higher than those reported in the general PD population. Except for few patients with perioperative cerebral hemorrhage, STN-DBS is cognitively safe, and does not provide dementia risk factors in addition to those reported for PD itself. Identification of dementia predictors in this population may improve patient selection and information concerning the risk of poor cognitive outcome.
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