Objective: Neurocognitive deterioration study in GBA-related Parkinson’s disease (GBA-PD) following Deep Brain stimulation Surgery of the Sub Thalamic Nuclei (STN-DBS)

Background: A faster progress of Parkinson’s Disease (PD) associated with pathogenic variants in the GBA gene is generally observed. Indeed, GBA-PD is linked to earlier cognitive impairment and psychosis. The motor benefit of STN-DBS is well-established in PD. However, the overall benefit of the procedure in GBA-PD is subject to controversy given the accelerated cognitive deterioration in this population.

Method: Retrospective analysis of demographic and clinical data in GBA-PD patients following STN-DBS at the Movement Disorders clinic, Hadassah Medical center (Jerusalem, Israel).

Results: Fourteen GBA-PD patients with over one year of post-surgical follow-up of were included in this analysis. All individuals experienced a good motor outcome with a 65% median reduction of daily levodopa-equivalent dose (range 35-82).
Five years after the procedure, half of the patients started rivastigmine for clinically-significant cognitive impairments. Moreover, half of the patients used quetiapine for hallucinations.

Conclusion: While the motor benefit of STN-DBS in GBA-PD is lasting, continuous cognitive deterioration is expected. The question if DBS-STN accelerate the cognitive deterioration in GBA-PD is still open and therefore, until additional data is accumulated this procedure should not be avoided for GBA-PD patients with significant motor fluctuations

References: 1. Bove F, Mulas D, Cavallieri F, et al. Long-term Outcomes (15 Years) After Subthalamic Nucleus Deep Brain Stimulation in Patients With Parkinson Disease. Neurology 2021;10.1212/WNL.0000000000012246.
2. Mangone G, Bekadar S, Cormier-Dequaire F, et al. Early cognitive decline after bilateral subthalamic deep brain stimulation in Parkinson’s disease patients with GBA mutations. Parkinsonism & Related Disorders 2020;76:56–62.
3. Pal G, Mangone G, Hill EJ, et al. Parkinson disease and STN‐DBS : cognitive effects in GBA mutation carriers. Annals of Neurology 2022;ana.26302.
4. Parkinson Progression Marker Initiative. The Parkinson Progression Marker Initiative (PPMI). Prog Neurobiol 2011;95(4):629–635.
5. Parsons TD, Rogers SA, Braaten AJ, et al. Cognitive sequelae of subthalamic nucleus deep brain stimulation in Parkinson’s disease: a meta-analysis. Lancet Neurol 2006;5(7):578–588.

« Back to 2022 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/post-deep-brain-stimulation-cognitive-decline-in-gba-related-parkinsons-disease/