Deep brain stimulation and cognitive decline in Parkinson’s disease: The predictive value of electroencephalography

Some Parkinson’s disease (PD) patients treated with subthalamic nucleus deep brain stimulation (STN-DBS) develop new-onset cognitive decline. We examined whether clinical EEG recordings can be used to predict cognitive deterioration in PD patients undergoing STN-DBS. In this retrospective study, we...

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Bibliographic Details
Published in:	Journal of neurology Vol. 262; no. 10; pp. 2275 - 2284
Main Authors:	Markser, A., Maier, Franziska, Lewis, C. J., Dembek, T. A., Pedrosa, D., Eggers, C., Timmermann, L., Kalbe, E., Fink, G. R., Burghaus, Lothar
Format:	Journal Article
Language:	English
Published:	Berlin/Heidelberg Springer Berlin Heidelberg 01-10-2015 Springer Nature B.V
Subjects:	Aged Brain research Cognition Disorders - diagnosis Cognition Disorders - etiology Cognitive ability Deep brain stimulation Deep Brain Stimulation - adverse effects Dementia Disease Electrodes, Implanted - adverse effects Electroencephalography Electroencephalography - methods Female Gerontology Humans Male Medicine Medicine & Public Health Middle Aged Neurology Neuropsychology Neuroradiology Neurosciences Original Communication Outcome Assessment (Health Care) Parkinson Disease - physiopathology Parkinson Disease - therapy Parkinson's disease Patients Physiology Predictive Value of Tests Prognosis Regression analysis Subthalamic Nucleus - surgery Surgery Germany Cognitive decline Electroencephalogram Deep brain stimulation Grand total EEG score Parkinson’s disease Dementia
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Summary:	Some Parkinson’s disease (PD) patients treated with subthalamic nucleus deep brain stimulation (STN-DBS) develop new-onset cognitive decline. We examined whether clinical EEG recordings can be used to predict cognitive deterioration in PD patients undergoing STN-DBS. In this retrospective study, we used the Grand Total EEG (GTE)-score (short and total) to evaluate pre- and postoperative EEGs. In PD patients undergoing STN-DBS ( N = 30), cognitive functioning was measured using Mini-Mental State Test and DemTect before and after surgery. Severity of motor impairment was assessed using the Unified Parkinson’s Disease Rating Scale-III. Patients were classified into patients with or without cognitive decline after STN-DBS surgery. Epidemiological data, pre- and postoperative EEG recordings as well as neuropsychological and neurological data, electrode positions and the third ventricle width were compared. A logistic regression model was used to identify predictors of cognitive decline. Motor deficits significantly improved from pre- to post-surgery, while the mean GTE-scores increased significantly. Six patients developed cognitive deterioration 4–12 months postoperatively. These patients had significantly higher preoperative GTE-scores than patients without cognitive deterioration, although preoperative cognitive functioning was comparable. Electrode positions, brain atrophy and neurological data did not differ between groups. Logistic regression analysis identified the GTE-score as a significant predictor of postoperative cognitive deterioration. Data suggest that the preoperative GTE-score can be used to identify PD patients that are at high risk for developing cognitive deterioration after STN-DBS surgery even though their preoperative cognitive state was normal.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0340-5354 1432-1459
DOI:	10.1007/s00415-015-7839-8