Nomogram to Predict Cognitive State Improvement after Deep Brain Stimulation for Parkinson's Disease

Area of Science:

• Neuroscience
• Neurology
• Medical Technology

Background:

• Cognitive impairment is a significant non-motor symptom in Parkinson's disease (PD).
• Bilateral subthalamic nucleus deep brain stimulation (STN-DBS) is a recognized treatment for PD motor symptoms.
• Predicting cognitive changes after STN-DBS is crucial for patient management.

Purpose of the Study:

• To develop and validate a nomogram for predicting cognitive improvement rates in PD patients following STN-DBS.
• To identify key factors influencing cognitive status changes one year after STN-DBS.

Main Methods:

• Retrospective analysis of 103 PD patients who underwent STN-DBS.
• Assessment of cognitive improvement using Montreal Cognitive Assessment (MoCA) scores one year post-surgery.
• Logistic regression analysis to identify predictive factors; nomogram construction and validation using ROC analysis, calibration plots, and decision curve analysis (DCA).

Main Results:

• The mean MoCA score improvement was 37.3%, with 64% of patients showing cognitive improvement.
• Independent predictors of cognitive improvement included years of education, UPDRS-III score with medication, and pre-operative MoCA and MMSE scores.
• The developed nomogram demonstrated high predictive accuracy (C-index=0.98, AUC=0.98) and good calibration.

Conclusions:

• The established nomogram effectively predicts the likelihood of significant cognitive improvement one year after STN-DBS in PD patients.
• This predictive model offers valuable insights for clinicians assessing potential cognitive outcomes in PD patients undergoing STN-DBS.