Session Information
Date: Saturday, October 6, 2018
Session Title: Surgical Therapy: Parkinson's Disease
Session Time: 1:45pm-3:15pm
Location: Hall 3FG
Objective: Our study aimed to evaluate the motor and cognitive outcome after Deep Brain Stimulation (DBS) in GBA-related PD.
Background: Parkinson’s disease (PD) patients carrying a glucocerebrosidase gene mutation (GBA-related PD) have been associated to worse cognitive decline after DBS, although the overall response to DBS is still poorly understood.
Methods: Comparison of motor and cognitive outcomes between GBA-related PD and idiopathic PD (iPD) patients after subthalamic nucleus (STN)-DBS. Pre- and post-DBS MDS-UPDRS and MMSE were assessed. Post-DBS evaluations were performed in 4 conditions concerning ON/OFF medication and/or stimulation.
Results: Eight GBA-related PD and 10 iPD patients, with no significant differences in gender, age at disease onset (AO), time to DBS, pre-DBS levodopa response, follow-up post-DBS and pre- and post-DBS levodopa equivalent daily dose. Post-DBS MDS-UPDRS-III MedON/StimON was significantly different between groups (40.1±9.1 GBA-PD; 28.8±11.2 iPD; P=0.05). In GBA-related PD, post-DBS MDS-UPDRS-III MedON/StimON was worse than pre-DBS MDS-UPDRS-III MedON (40.1±9.1 vs 24.5±8; P=0.017). MMSE did not differ significantly between groups. 6/8 GBA-related PD patients were evaluated in the 4 post-DBS conditions. Stimulation significantly improved MDS-UPDRS-III (MedOFF/StimOFF 57.7±14.8 vs MedOFF/StimON 36.7±14.3; P=0.026), but the benefit with stimulation (post-DBS MDS-UPDRS-III MedOFF/StimOFF vs MedOFF/StimON) was worse compared to benefit from levodopa pre-DBS (pre-DBS MedOFF vs MedON).
Conclusions: GBA-related PD patients benefit from acute STN-DBS stimulation, although less than iPD patients. Motor symptoms of GBA-related PD seem to worsen 4.5 years after STN-DBS, whereas we found no cognitive decline. More data is warranted but available evidence do not support excluding GBA-related PD patients from DBS. Abstract presented at the 4th Congress of the European Academy of Neurology, 16-19 June 2018, Lisbon, Portugal
To cite this abstract in AMA style:
L. Correia Guedes, C. Silva, R. Machado Bouça, N. Gonçalves, M. Fabbri, A. Castro Caldas, P. Pita Lobo, M.M. Rosa, B. Cattoni, H. Carvalho, A. Gonçalves Ferreira, J.J. Ferreira, M. Coelho. Motor and cognitive progression in GBA-related PD patients submitted to Deep Brain Stimulation [abstract]. Mov Disord. 2018; 33 (suppl 2). https://www.mdsabstracts.org/abstract/motor-and-cognitive-progression-in-gba-related-pd-patients-submitted-to-deep-brain-stimulation/. Accessed November 22, 2024.« Back to 2018 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/motor-and-cognitive-progression-in-gba-related-pd-patients-submitted-to-deep-brain-stimulation/