Objective: To evaluate the impact of deep brain stimulation (DBS) on cognition and affect in Parkinson’s Disease (PD) patients of low socioeconomic status (SES).

Background: In a prior study, we demonstrated that DBS can improve quality of life in a low SES population by reducing symptom burden (Nguyen et. al., MDS-PAS 2024). DBS is an excellent adjunct to medical management particularly pertaining to motor function. This benefit is not as strong for the cognitive, affective, and the gait aspects of PD (Mehanna et al., 2017). Some studies show that implants in the GPi may be beneficial in offsetting these non-motor symptoms (Williams et. Al., 2014).

Method: This was a sub analysis of our prior study; 20 PD patients’ (with low SES based on neighborhood) survey responses regarding cognition and affect were collected pre- and post- DBS implant. Their pre-implant qualitative survey responses were compared to their post-implant responses. This data was examined using several variables, such as location of implant (GPi vs STN) and level of social support (marital status).

Results: Twenty five percent of patients reported an improvement in cognitive impairment, but 35% reported worsening and 10% reported no change. 30% never had symptoms. Forty five percent reported improved depression, while 25% reported worsening, 10% had no change. 20% never had symptoms. Forty five percent reported improved anxiety, 15% reported worsening, and 15% had no change. 25% never had symptoms. Those who never developed symptoms were not accounted for in the no change cohorts. 

There was no significant difference between pre-implant and post-implant survey responses when analyzed by location of implant [cognition (F(1,36)=3.8549, p=0.05736); depression (F(1,36)=1.0022, p=0.3235); anxiety (F(1,36)=0.7925,p=0.3793] or marital status [cognition (F( 1,36)=0.1562, p=0.695); depression (F(1, 36)=0.0142, p=0.9058); anxiety (F(1,36)=0.0479, p=0.828)].

Conclusion: Though DBS is efficacious in improving quality of life in PD patients of low SES, it did not demonstrate a similar benefit on cognition. However, it did demonstrate a potential improvement in affect. There was no significant difference seen on either, based on location of DBS implant or level of social support. Patients in this population would benefit from a multimodal approach to improve the non-motor aspects of their condition.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effect-on-cognition-and-affect-in-patients-with-deep-brain-stimulation-for-parkinsons-disease-from-low-socioeconomic-status/