Dementia and subthalamic deep brain stimulation in Parkinson disease: A long-term overview.

Bove, Francesco; Fraix, Valerie; Cavallieri, Francesco; Schmitt, Emmanuelle; Lhommée, Eugénie; Bichon, Amélie; Meoni, Sara; Pélissier, Pierre; Kistner, Andrea; Chevrier, Eric; Ardouin, Claire; Limousin, Patricia; Krack, Paul; Benabid, Alim Louis; Chabardès, Stephan; Seigneuret, Eric; Castrioto, Anna; Moro, Elena (2020). Dementia and subthalamic deep brain stimulation in Parkinson disease: A long-term overview. Neurology, 95(4), e384-e392. American Academy of Neurology 10.1212/WNL.0000000000009822

Text Bove, 2020, dementia STN DBS in PD.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Download (544kB)

OBJECTIVES

To assess the prevalence and the cumulative incidence of dementia at short-, medium- and long-term follow-up after deep brain stimulation (DBS) of the subthalamic nucleus (STN) (at 1, 5, and 10 years) and to evaluate potential risk factors for postoperative dementia.

METHODS

The presence of dementia (according to the DSM-V) was retrospectively evaluated at each postoperative follow-up in patients with Parkinson disease (PD) who underwent bilateral STN-DBS. Preoperative and perioperative risk factors of developing postoperative dementia were also investigated. Demographic data, disease features, medications, comorbidities, nonmotor symptoms, PD motor scales, neuropsychological scales at baseline, and perioperative complications were collected for each patient.

RESULTS

A total of 175 patients were included, and 104 were available at 10-year follow-up. Dementia prevalence was 2.3% at 1 year, 8.5% at 5 years, and 29.8% at 10 years. Dementia cumulative incidence at 1, 5, and 10 years was 2.3%, 10.9%, and 25.7%, respectively. The corresponding dementia incidence rate was 35.6 per 1,000 person-years. Male sex, higher age, hallucinations, lower frontal score at baseline, and perioperative cerebral hemorrhage were predictors of dementia.

CONCLUSIONS

In patients with PD with longstanding STN-DBS, dementia prevalence and incidence are not higher than those reported in the general PD population. Except for few patients with perioperative cerebral hemorrhage, STN-DBS is cognitively safe, and does not provide dementia risk factors in addition to those reported for PD itself. Identification of dementia predictors in this population may improve patient selection and information concerning the risk of poor cognitive outcome.

Interest & Impact

Downloads

1 since deposited on 10 Nov 2020
0 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item