Developments in the prediction of cognitive changes following deep brain stimulation in persons with Parkinson's disease.

Document Type

Article

Abstract

INTRODUCTION: Deep brain stimulation (DBS) is an effective treatment for Parkinson's disease (PD) motor symptoms that improves function and quality of life in appropriately selected patients. Because mild to moderate cognitive declines can follow DBS and impact quality of life in a minority of patients, an important consideration involves the cognitive deficit and its prediction.

AREAS COVERED: The author briefly summarizes cognitive outcomes from DBS and reviews in more detail the risks/predictors of post-DBS cognitive dysfunction by mainly focusing on work published between 2018 and 2024 and using comprehensive neuropsychological (NP) evaluations. Most publications concern bilateral subthalamic nucleus (STN) DBS. Comment is offered on challenges and potential avenues forward.

EXPERT OPINION: STN DBS is relatively safe cognitively but declines occur especially in verbal fluency and executive function/working memory. Numerous predictors and risk factors for cognitive outcomes have been identified (age and pre-operative neuropsychological status appear the most robust) but precise risk estimates cannot yet be confidently offered. Future studies should employ study center consortia, follow uniform reporting criteria (to be developed), capitalize on advances in stimulation, biomarkers, and artificial intelligence, and address DBS in diverse groups. Advances offer an avenue to investigate the amelioration of cognitive deficits in PD using neuromodulation.

Medical Subject Headings

Humans; Deep Brain Stimulation; Parkinson Disease; Cognitive Dysfunction; Subthalamic Nucleus; Neuropsychological Tests; Quality of Life; Risk Factors

Publication Date

7-1-2024

Publication Title

Expert Rev Neurother

ISSN

1744-8360

Volume

24

Issue

7

First Page

643

Last Page

659

PubMed ID

38814926

Digital Object Identifier (DOI)

10.1080/14737175.2024.2360121

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