Sarno Marina, Harcourt Scott, Bure-Reyes Annelly, Jagid Jonathan, Luca Corneliu, Levin Bonnie, Haq Ihtsham
University of Miami, Department of Neurology, 1150 NW 14th Street Miami, Florida 33136, USA.
Clin Park Relat Disord. 2025 Jun 27;13:100361. doi: 10.1016/j.prdoa.2025.100361. eCollection 2025.
Subcortical deficits in Parkinson's disease (PD) are well studied; however, deep brain stimulation (DBS) risks posed by mild-moderate deficits in semantic fluency, verbal memory storage, and confrontation naming are not as well understood. This study aims to better define DBS risk stratification criteria by evaluating whether pre-DBS cortical domain deficits predict surgical outcomes, including cognition, mood, quality of life, medication and motor function in patients with PD.
A retrospective study was conducted with 50 PD patients who underwent pre- and post-surgical neurological and neuropsychological evaluations between 2015 and 2023. Patients were categorized into normal, mildly impaired, and moderately impaired cognitive groups based on pre-surgical neuropsychological testing. Bayesian paired-sample t-tests compared pre- and post-surgery outcomes in motor function, medication use, quality of life, mood, and cognition.
No significant differences were found in demographic or clinical variables across cognitive groups. In the normal cognition group, there was a credible decline in memory and anxiety. The mildly impaired group showed a weak decline in delayed word list memory. The moderately impaired group had no significant changes in cognitive or mood variables. Medication use reliably decreased post-surgically across all groups. There was no significant change in motor function or quality of life post-DBS.
Mild to moderate cognitive impairments in memory and language do not significantly affect post-surgical outcomes. Our preliminary findings warrant further confirmation with larger sample sizes and long-term follow-up when assessing DBS candidacy in those with pre-surgical cognitive deficits. Comprehensive neuropsychological evaluations can assist in proper risk stratification and informed patient selection.
帕金森病（PD）的皮质下功能缺陷已得到充分研究；然而，语义流畅性、言语记忆存储和对答命名方面的轻度至中度缺陷所带来的深部脑刺激（DBS）风险尚未得到很好的理解。本研究旨在通过评估术前皮质区域缺陷是否能预测手术结果，包括PD患者的认知、情绪、生活质量、药物治疗和运动功能，从而更好地定义DBS风险分层标准。
对2015年至2023年间接受术前和术后神经学及神经心理学评估的50例PD患者进行了一项回顾性研究。根据术前神经心理学测试，将患者分为认知正常、轻度受损和中度受损三组。采用贝叶斯配对样本t检验比较手术前后运动功能、药物使用、生活质量、情绪和认知方面的结果。
各认知组在人口统计学或临床变量方面未发现显著差异。在认知正常组中，记忆和焦虑有可信的下降。轻度受损组在延迟单词列表记忆方面有微弱下降。中度受损组在认知或情绪变量方面无显著变化。所有组术后药物使用均可靠减少。DBS术后运动功能或生活质量无显著变化。
记忆和语言方面的轻度至中度认知障碍不会显著影响术后结果。我们的初步研究结果需要在评估术前有认知缺陷患者的DBS候选资格时，通过更大样本量和长期随访进一步证实。全面的神经心理学评估有助于进行适当的风险分层和明智的患者选择。
