Patients with Cognitive Impairment in Parkinson's Disease Benefit from Deep Brain Stimulation: A Case-Control Study

Area of Science:

• Neurology
• Neurosurgery
• Cognitive Science

Background:

• Deep brain stimulation (DBS) for Parkinson's disease (PD) is typically not recommended for patients with dementia.
• Current guidelines for DBS in PD are based on studies of patients with mild cognitive impairment or normal cognition.

Purpose of the Study:

• To evaluate the efficacy of DBS in Parkinson's disease patients with moderate cognitive impairment, including those with mild dementia.
• To assess both motor and non-motor outcomes in this patient cohort.

Main Methods:

• A retrospective case-control study involving 40 PD patients with moderate cognitive impairment (CI) and 40 matched PD patients with normal cognition (NC).
• Surgical targets included subthalamus, pallidus, or motor thalamus, with unilateral, bilateral, or staged approaches.
• Clinical outcomes were compared at 1-year follow-up.

Main Results:

• The CI cohort showed similar improvements in motor scores, motor fluctuations, and medication reduction compared to the NC cohort post-surgery.
• Both groups exhibited comparable rates of adverse events.
• Outcomes in the CI group were not influenced by the specific surgical target, staging, or the cognitive domain affected.

Conclusions:

• Parkinson's disease patients with moderate cognitive impairment can achieve significant motor benefits from DBS.
• DBS can lead to meaningful medication reduction in this population.
• These findings suggest that DBS may be a viable option for selected PD patients with cognitive impairment.