Kübler-Weller Dorothee, Stuke Heiner, Astalosch Melanie, Martins Ribeiro Luísa, Landfried Elias, Schneider Gerd-Helge, Faust Katharina, Krause Patricia, Roediger Jan, Haufe Stefan, Mousavi Mahta, Al-Fatly Bassam, Spies Claudia, Borchers Friedrich, Kühn Andrea A
Movement Disorder and Neuromodulation Unit, Department of Neurology and Experimental Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu, Berlin, Germany.
Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany.
NPJ Parkinsons Dis. 2025 Aug 28;11(1):265. doi: 10.1038/s41531-025-01128-3.
Cognitive deficits have a high impact on quality of life in Parkinson's disease (PD). This study takes into account the multifaceted etiology of cognition to estimate the cognitive outcome after deep brain stimulation (DBS) surgery in PD. Clinical, neuropsychological, perioperative, neuroimaging- and laboratory-based risk factors for cognitive dysfunction were prospectively assessed prior to surgery in 57 patients (21 female; age 60.2 ± 8.2; disease duration 10.5 ± 5.9 years, preregistered 9 June 2019 at clinicaltrials.gov, NCT03982953). Elastic net regularized regression and leave-one-out cross-validation were used to fit a multivariable model with the Montréal Cognitive Assessment (MoCA) change one year after surgery as primary outcome. The backward span had the most robust association with the cognitive outcome (rho = 0.499, p < 0.001**; c = 0.302). We propose a post-hoc prediction model for cognition based on the baseline MoCA and backward span (R² = 0.50). After clinical validation, our short and easily applicable prediction model could improve informed therapeutic decision making.
认知缺陷对帕金森病（PD）患者的生活质量有很大影响。本研究考虑到认知的多方面病因，以评估帕金森病患者接受脑深部电刺激（DBS）手术后的认知结果。在57例患者（21例女性；年龄60.2±8.2岁；病程10.5±5.9年，于2019年6月9日在clinicaltrials.gov预注册，NCT03982953）手术前，前瞻性评估了认知功能障碍的临床、神经心理学、围手术期、神经影像学和实验室相关危险因素。采用弹性网络正则化回归和留一法交叉验证，以术后一年蒙特利尔认知评估（MoCA）变化作为主要结局，拟合多变量模型。倒背广度与认知结果的关联最为显著（rho = 0.499，p < 0.001**；c = 0.302）。我们基于基线MoCA和倒背广度提出了一种事后认知预测模型（R² = 0.50）。经过临床验证，我们简短且易于应用的预测模型可改善明智的治疗决策。
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