Session Information
Date: Thursday, June 8, 2017
Session Title: Parkinson’s Disease: Clinical Trials, Pharmacology And Treatment
Session Time: 1:15pm-2:45pm
Location: Exhibit Hall C
Objective: We evaluated postoperative change of visuospatial impairment in the patients with Parkinson’s disease (PD) underwent deep brain stimulation (DBS) to assess the impact of chronic stimulation and discussed factors associated with DBS-related change.
Background: PD patients commonly have cognitive impairments including executive, memory, and visual perception deficits1. Visuospatial perception deficits in PD might relate to symptoms of freezing of gait or visual hallucinations. To date, there are previous reports on cognitive outcome after subthalamic nucleus (STN) DBS2; however, the effects of surgery on visuospatial cognitive function are still the subject of controversy. In this study, we investigated the effect of DBS to visuospatial cognition in PD patients.
Methods: Thirty consecutive patients with PD who underwent bilateral STN (n=27) or Globus pallidus internus (n=3) DBS were included in this study. The median age was 66.5 years (IQR 61-68). The median disease duration was 13 years (IQR 10- 15 years). Mean Unified Parkinson’s Disease Rating Scale (UPDRS) Part III was (on/off) 17.2 ± 7.9/ 44.1 ± 14.3 (mean ± S.D.). L-dopa equivalent dose (LED) was 1090 ± 263 mg. Median MMSE was 30 (range 26-30). We performed Rey-Osterrieth Complex Figure Test (ROCFT) before and one year after surgery. Clinical factors, such as age, gender, preoperative cognitive function (Wechsler Adult Intelligence Scale [WAIS] III), family history, and disease duration were also evaluated.
Results: We found significant deterioration in copy accuracy of ROCFT after surgery (p= 0.028), however no significant difference in immediate recall accuracy between before and after surgery. An over 10% decrease in copy accuracy correlated with the low scores of verbal comprehension, working memory in preoperative WAIS III (Spearman’s rank correlation coefficient, p= 0.017, 0.047). Age, disease duration, gender or preoperative motor scores were not associated with deterioration of copy accuracy.
Conclusions: Chronic stimulation might affect visuospatial cognition in PD patients. The pre-existing impairment of cognitive function might be a risk factor for deterioration of visuospatial impairment.
References: 1. Barone P et al. Cognitive impairment in nondemented Parkinson’s disease. Mov Disord (2011) 26:2483–95.
2. Parsons et al. Cognitive sequelae of subthalamic nucleus deep brain stimulation in Parkinson’s disease: a meta-analysis. Lancet Neurol (2006);5: 578-88.
To cite this abstract in AMA style:
Y. Okahara, Y. Higuchi, K. Aoyagi, M. Abe, T. Yamamoto, Y. Yamanaka, S. Hirano, Y. Iwadate. Effect of deep brain stimulation on visuospatial impairment in Parkinson’s disease [abstract]. Mov Disord. 2017; 32 (suppl 2). https://www.mdsabstracts.org/abstract/effect-of-deep-brain-stimulation-on-visuospatial-impairment-in-parkinsons-disease/. Accessed November 21, 2024.« Back to 2017 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/effect-of-deep-brain-stimulation-on-visuospatial-impairment-in-parkinsons-disease/