TY - JOUR
T1 - Impact of mild cognitive impairment on outcome following deep brain stimulation surgery for Parkinson's disease
AU - Abboud, Hesham
AU - Floden, Darlene
AU - Thompson, Nicolas R.
AU - Genc, Gencer
AU - Oravivattanakul, Srivadee
AU - Alsallom, Faisal
AU - Swa, Bengwei
AU - Kubu, Cynthia
AU - Pandya, Mayur
AU - Gostkowski, Michal
AU - Cooper, Scott
AU - Machado, Andre G.
AU - Fernandez, Hubert H.
N1 - Publisher Copyright:
© 2014 Elsevier Ltd.
PY - 2015/3/1
Y1 - 2015/3/1
N2 - Introduction: Unlike dementia, the effect of mild cognitive impairment (MCI) on outcomes after deep brain stimulation (DBS) in Parkinson's disease (PD) is less clear. We aimed to examine the effect of MCI on short- and long-term DBS outcomes. Methods: To study the effect of MCI type, cognitive domains (attention, language, visuospatial, memory, executive function), and Dementia Rating Scale (DRS) score on immediate postoperative outcomes (postoperative confusion, hospitalization days), PD patients who underwent DBS at our Center from 2006 to 2011 were analyzed. To determine cognitive predictors of intermediate (6-month) and long-term (1-year) post-operative outcomes, the changes in functional and quality-of-life (QOL) scores were analyzed in a smaller group with available preoperative health status measures. Results: We identified 130 patients [71% male, mean age: 63±9.1, mean PD duration: 10.7±5.1]. At preoperative assessment, 60% of patients had multiple-domain MCI, 21% had single-domain MCI, and 19% had normal cognition. MCI presence and type as well as DRS performance did not affect immediate outcomes. Attention impairment predicted longer postoperative hospitalization (P=0.0015) and showed a trend towards occurrence of postoperative confusion (P=0.089).For intermediate and long-term outcomes we identified 56 patients [73.2% male, mean age: 61.3±9.6, mean PD duration: 10.6±4.7]. Visuospatial impairment showed a trend towards less improvement in 6-month functional score (P=0.0652), and 1-year QOL score (P=0.0517). Conclusion: The presence of MCI did not affect DBS outcomes. However, the types of impaired domains were more detrimental. Detailed cognitive testing can help stratify low- and high-risk patients based on their pattern of cognitive dysfunction.
AB - Introduction: Unlike dementia, the effect of mild cognitive impairment (MCI) on outcomes after deep brain stimulation (DBS) in Parkinson's disease (PD) is less clear. We aimed to examine the effect of MCI on short- and long-term DBS outcomes. Methods: To study the effect of MCI type, cognitive domains (attention, language, visuospatial, memory, executive function), and Dementia Rating Scale (DRS) score on immediate postoperative outcomes (postoperative confusion, hospitalization days), PD patients who underwent DBS at our Center from 2006 to 2011 were analyzed. To determine cognitive predictors of intermediate (6-month) and long-term (1-year) post-operative outcomes, the changes in functional and quality-of-life (QOL) scores were analyzed in a smaller group with available preoperative health status measures. Results: We identified 130 patients [71% male, mean age: 63±9.1, mean PD duration: 10.7±5.1]. At preoperative assessment, 60% of patients had multiple-domain MCI, 21% had single-domain MCI, and 19% had normal cognition. MCI presence and type as well as DRS performance did not affect immediate outcomes. Attention impairment predicted longer postoperative hospitalization (P=0.0015) and showed a trend towards occurrence of postoperative confusion (P=0.089).For intermediate and long-term outcomes we identified 56 patients [73.2% male, mean age: 61.3±9.6, mean PD duration: 10.6±4.7]. Visuospatial impairment showed a trend towards less improvement in 6-month functional score (P=0.0652), and 1-year QOL score (P=0.0517). Conclusion: The presence of MCI did not affect DBS outcomes. However, the types of impaired domains were more detrimental. Detailed cognitive testing can help stratify low- and high-risk patients based on their pattern of cognitive dysfunction.
KW - Deep brain stimulation
KW - Hospitalization
KW - Mild cognitive impairment
KW - Parkinson's disease
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U2 - 10.1016/j.parkreldis.2014.12.018
DO - 10.1016/j.parkreldis.2014.12.018
M3 - Article
C2 - 25578289
AN - SCOPUS:84923251188
SN - 1353-8020
VL - 21
SP - 249
EP - 253
JO - Parkinsonism and Related Disorders
JF - Parkinsonism and Related Disorders
IS - 3
ER -