Journal of Neurology

, Volume 261, Issue 9, pp 1745–1751

Subthalamic deep brain stimulation: clinical and neuropsychological outcomes in mild cognitive impaired parkinsonian patients

  • Aristide Merola
  • Laura Rizzi
  • Carlo Alberto Artusi
  • Maurizio Zibetti
  • Mario Giorgio Rizzone
  • Alberto Romagnolo
  • Andrea Bernardini
  • Michele Lanotte
  • Leonardo Lopiano
Original Communication

DOI: 10.1007/s00415-014-7414-8

Cite this article as:
Merola, A., Rizzi, L., Artusi, C.A. et al. J Neurol (2014) 261: 1745. doi:10.1007/s00415-014-7414-8

Abstract

This observational study reports the long-term follow-up of 184 Parkinson’s disease (PD) patients treated with subthalamic deep brain stimulation (STN-DBS), retrospectively analyzing the outcomes of subjects with pre-surgical mild cognitive impairment (MCI) compared to those of patients with normal cognition. Patients were divided into PD-MCI or normal cognition groups at baseline, and then compared after 1, 3, 5 and >5 years of follow-up. Subjects assessed by outpatient clinical follow-up evaluation, not performing a complete clinical and neuropsychological follow-up assessment, were separately considered and rated according to their functional autonomy in daily living activities. The MCI prevalence at baseline was 23 %, increasing to 34 % at 1 year and over 40 % after 3 years. Dementia progressively affected more than 30 % of subjects after a median time of 6 years in the PD-MCI group and 11 years in the normal cognition group (p: 0.028). The mortality risk was slightly higher in PD-MCI patients. Outpatient clinical evaluations showed a progressive increase of subjects completely dependent in the activities of daily living, which ranged from the 11 % at 3 years to 23 % at 5 years and 31 % at >5 years. MCI can be frequently observed in PD patients, possibly influencing the outcome of surgical therapy. Our findings confirm the sustained long-lasting efficacy of STN-DBS on motor functions in both PD-MCI and normal cognition subjects. PD-MCI patients showed a more precocious cognitive impairment, as expected by natural history studies, but no case of dementia was observed early after surgery.

Keywords

Parkinson’s disease Dementia Mild cognitive impairment Deep brain stimulation Subthalamic nucleus 

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Aristide Merola
    • 1
  • Laura Rizzi
    • 1
  • Carlo Alberto Artusi
    • 1
  • Maurizio Zibetti
    • 1
  • Mario Giorgio Rizzone
    • 1
  • Alberto Romagnolo
    • 1
  • Andrea Bernardini
    • 1
  • Michele Lanotte
    • 1
  • Leonardo Lopiano
    • 1
  1. 1.Department of NeuroscienceUniversity of TurinTurinItaly

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