Objective: To study the performance of PD-CRS before and 2 years after STN-DBS and compare their results with other recognized cognitive scales.

Background: Parkinson´s disease (PD) is a disorder of basal ganglia circuit functions, and it is characterized by both motor and non-motor symptoms. Deep brain stimulation of subthalamic nucleus (STN-DBS) is a widely performed surgical method to treat advanced PD.  STN- DBS can alleviate motor symptoms of PD, but its effects on cognitive function remain unclear. After surgery some studies have found significant decline of verbal fluency and some deficits in inhibitory and executive control, and other works have found minor cognitive detrimental. The Parkinson’s Disease Cognitive Rating Scale (PD-CRS) was designed to evaluate and capture cortical and subcortical deficits in PD, but we don´t know if it can detect cognitive changes after STN-DBS. Also, any study has compared its performance with other cognitive scales

Method: We conducted a prospective study including 28 patients with PD who underwent STN-DBS (61,8 ± 5,6 years old; time evolution 11,5 ± ,3,8 years). All patients were assessed before STN-DBS and six moths after 2 years surgery. The cognitive battery included PD-CRS, Mini-Mental State Examination (MMSE), Mattis Dementia Rating Scale (MDRS) and verbal fluencies.

Results: Performance of PD-CRS two years after STN-DBS was significantly lower in the subtests of working memory (6,3 ± 1,8; 5,4 ± 1,6; p < .01); alternant fluency (11,9 ± 3,8; 8,8 ± 4; p < .000) and action fluency (15,8 ± 5,4; 12,7 ± 5,5; p < .001). Also, we found significantly lower performance in the total index: (91,6 ± 12,7; 86,2 ± 14,2; p < .042). Performance in the MDRS was significantly lower at two years in the subtest of initiation-perseveration (35,8 ± 2,2; 34,4 ± 3,2; p < .022). Not significant differences were found in the MMSE (28,4 ± 1,4; 27,9 ± 2,1).

Conclusion: After surgery, the PD-CRS showed a significantly lower performance in working memory, fluency task and total index, in line with previous published studies. The MDRS showed lower performance in the subtest of initiation-perseveration. We conclude that PD-CRS is a useful scale in the detection of cognitive changes of PD patients after STN-DBS.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/performance-of-parkinsons-disease-cognitive-scale-rating-scale-pd-crs-after-2-years-subthalamic-nucleus-deep-brain-stimulation-comparison-with-mattis-dementia-rating-scale-mdrs-and-mini-men/