Objective: To investigate the relationship between brain edema after deep brain stimulation (DBS) surgery and the function of motor and cognitive function.

Background: DBS surgery may be beneficial for the patient with Parkinson’s disease (PD). However, sometimes perifocal brain edema had occurred after DBS surgery. There are reports that edema is transient and has no effect on the final prognosis. However, the influence of edema is not clearly understood.

Method: Thirteen patients with PD who underwent bilateral subthalamic nucleus (STN) DBS were included. All patients underwent MRI examination on day 6 post DBS surgery.  We measured the volume of edema either in the frontal white matter or STN on FLAIR images. Finally, we examined the relationship between these volumes and changes in cognitive function or motor function.

Results: The average age was 61.2 years, with 6 males and 7 females. We divided 13 patients into those with frontal subcortical edema (FE) larger than 3,000 mm3 or less (7 patients in the FE+ group and 6 in the FE– group, respectively). In the FE+ group, the postoperative MMSE score worsened by 2.4 points after one week compared with that immediately after surgery, while the FE- group improved MMSE score by 0.7 points (p<0.01). We divided 13 patients into those with STN edema (SE) larger than 1,000 mm3 or less (3 patients in the SE+ group and 10 in the SE- group, respectively). By comparing SE + with SE -, we observed a tendency for motor function deterioration to occur after more than 20 days postoperatively.

Conclusion: The frontal subcortical edema after DBS surgery was related to transient cognitive decline. On the other hand, cerebral edema near the target was suggested to be associated with micro-lesioning effects.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-relationship-between-brain-edema-after-deep-brain-stimulation-surgery-and-the-function-of-motor-and-cognition/