Objective: We aimed to examine the relationship between pulse wave velocity (PWV) at pre- deep brain stimulation (DBS) stage and symptoms change at post-DBS stage.

Background: Cognitive dysfunction and reduced rate of symptom improvement have been reported in DBS for elderly patients with Parkinson’s disease, but still DBS may be very effective in some patients. We focused on preoperative PWV because atherosclerotic changes are closely associated with aging.

Method: We calculated vascular age by comparing PWV and actual age in 32 Parkinson’s disease patients who received DBS from January 2014 to May 2018. In 27 of 32 patients with  Parkinson’s disease targeting the subthalamic nucleus, the average age was 63.3 ± 7.5 years, the averaged disease duration was 11.4 ± 4.0 years, and the averaged preoperative Hoehn& Yahr stage at off state was 4.4 ± 0.6. The analysis was performed on 26 subjects, excluding one who lacked postoperative evaluation data. We evaluated age at surgery and vascular age and disease duration, deep white matter lesions (WML), UPDRS before and 3 months after surgery, ADL independence, and Hoehn & Yahr stage.

Results: A significant correlation for both actual and vascular age were obtained with the Hoehn & Yahr stage at the time of postoperative on and off state (age: r = 0.60, p <0.01, r = 0.53, p <0.01 Vascular age: r = 0.56, p <0.01 , R = 0.36, p = 0.04, respectively). In actual age analysis, a significant correlation was obtained with on state UPDRS part II score and off-state ADL independence improvement rate at 3 months later of DBS surgery (r=0.37, 0.46, p=0.03, <0.01, respectively). In vascular age analysis, a significant correlation was observed with on state UPDRS part III at 3 months later of DBS surgery (r=0.50, 0.44, p<0.01, =0.01, respectively).
In multivariate analysis using on state UPDRS part III score at 3 months later of DBS surgery as a dependent variable, a statistical significance was obtained only for vascular age among the on state UPDRS part III score at baseline, actual age and vascular age (P = 0.014).

Conclusion: This study suggests that on state UPDRS part II and UPDRS total score at 3 months later of DBS surgery correlate better with vascular age than actual age. Therefore, adding vascular age based on PWV to actual age may help predict the prognosis after DBS surgery.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/vascular-age-calculated-by-pulse-wave-velocity-may-help-predict-the-prognosis-after-deep-brain-stimulation-surgery-in-patients-with-parkinsons-disease/