Francesco Bove1, Valerie Fraix1, Francesco Cavallieri1, Emmanuelle Schmitt1, Eugénie Lhommée1, Amélie Bichon1, Sara Meoni1, Pierre Pélissier1, Andrea Kistner1, Eric Chevrier1, Claire Ardouin1, Patricia Limousin1, Paul Krack1, Alim Louis Benabid1, Stephan Chabardès1, Eric Seigneuret1, Anna Castrioto1, Elena Moro2. 1. From the Movement Disorders Unit (F.B., V.F., F.C., E.S., E.L., A.B., S.M., P.P., A.K., E.C., C.A., P.K., A.C., E.M.) and Neurosurgery Department (A.L.B., S.C., E.S.), CHU Grenoble Alpes, France; Institute of Neurology (F.B.), Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Del Sacro Cuore, Rome, Italy; U1216 (V.F., E.S., E.L., A.B., S.M., P.P., A.K., E.C., C.A., P.K., A.L.B., S.C., E.S., A.C., E.M.), Grenoble Institut des Neurosciences, Inserm, Université Grenoble Alpes, France; Neurology Unit (F.C.), Neuromotor & Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia; Clinical and Experimental Medicine PhD Program (F.C.), University of Modena and Reggio Emilia, Modena; Department of Clinical and Movement Neurosciences (P.L.), University College London Queen Square Institute of Neurology, UK; and Department of Neurology (P.K.), INSELSPITAL, University Hospital Bern, Switzerland. 2. From the Movement Disorders Unit (F.B., V.F., F.C., E.S., E.L., A.B., S.M., P.P., A.K., E.C., C.A., P.K., A.C., E.M.) and Neurosurgery Department (A.L.B., S.C., E.S.), CHU Grenoble Alpes, France; Institute of Neurology (F.B.), Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Del Sacro Cuore, Rome, Italy; U1216 (V.F., E.S., E.L., A.B., S.M., P.P., A.K., E.C., C.A., P.K., A.L.B., S.C., E.S., A.C., E.M.), Grenoble Institut des Neurosciences, Inserm, Université Grenoble Alpes, France; Neurology Unit (F.C.), Neuromotor & Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia; Clinical and Experimental Medicine PhD Program (F.C.), University of Modena and Reggio Emilia, Modena; Department of Clinical and Movement Neurosciences (P.L.), University College London Queen Square Institute of Neurology, UK; and Department of Neurology (P.K.), INSELSPITAL, University Hospital Bern, Switzerland. elenamfmoro@gmail.com.
Abstract
OBJECTIVES: To assess the prevalence and the cumulative incidence of dementia at short-, medium- and long-term follow-up after deep brain stimulation (DBS) of the subthalamic nucleus (STN) (at 1, 5, and 10 years) and to evaluate potential risk factors for postoperative dementia. METHODS: The presence of dementia (according to the DSM-V) was retrospectively evaluated at each postoperative follow-up in patients with Parkinson disease (PD) who underwent bilateral STN-DBS. Preoperative and perioperative risk factors of developing postoperative dementia were also investigated. Demographic data, disease features, medications, comorbidities, nonmotor symptoms, PD motor scales, neuropsychological scales at baseline, and perioperative complications were collected for each patient. RESULTS: A total of 175 patients were included, and 104 were available at 10-year follow-up. Dementia prevalence was 2.3% at 1 year, 8.5% at 5 years, and 29.8% at 10 years. Dementia cumulative incidence at 1, 5, and 10 years was 2.3%, 10.9%, and 25.7%, respectively. The corresponding dementia incidence rate was 35.6 per 1,000 person-years. Male sex, higher age, hallucinations, lower frontal score at baseline, and perioperative cerebral hemorrhage were predictors of dementia. CONCLUSIONS: In patients with PD with longstanding STN-DBS, dementia prevalence and incidence are not higher than those reported in the general PD population. Except for few patients with perioperative cerebral hemorrhage, STN-DBS is cognitively safe, and does not provide dementia risk factors in addition to those reported for PD itself. Identification of dementia predictors in this population may improve patient selection and information concerning the risk of poor cognitive outcome.
OBJECTIVES: To assess the prevalence and the cumulative incidence of dementia at short-, medium- and long-term follow-up after deep brain stimulation (DBS) of the subthalamic nucleus (STN) (at 1, 5, and 10 years) and to evaluate potential risk factors for postoperative dementia. METHODS: The presence of dementia (according to the DSM-V) was retrospectively evaluated at each postoperative follow-up in patients with Parkinson disease (PD) who underwent bilateral STN-DBS. Preoperative and perioperative risk factors of developing postoperative dementia were also investigated. Demographic data, disease features, medications, comorbidities, nonmotor symptoms, PD motor scales, neuropsychological scales at baseline, and perioperative complications were collected for each patient. RESULTS: A total of 175 patients were included, and 104 were available at 10-year follow-up. Dementia prevalence was 2.3% at 1 year, 8.5% at 5 years, and 29.8% at 10 years. Dementia cumulative incidence at 1, 5, and 10 years was 2.3%, 10.9%, and 25.7%, respectively. The corresponding dementia incidence rate was 35.6 per 1,000 person-years. Male sex, higher age, hallucinations, lower frontal score at baseline, and perioperative cerebral hemorrhage were predictors of dementia. CONCLUSIONS: In patients with PD with longstanding STN-DBS, dementia prevalence and incidence are not higher than those reported in the general PD population. Except for few patients with perioperative cerebral hemorrhage, STN-DBS is cognitively safe, and does not provide dementia risk factors in addition to those reported for PD itself. Identification of dementia predictors in this population may improve patient selection and information concerning the risk of poor cognitive outcome.
Authors: Sina R Potel; Sara Marceglia; Sara Meoni; Suneil K Kalia; Rubens G Cury; Elena Moro Journal: Curr Neurol Neurosci Rep Date: 2022-07-15 Impact factor: 6.030
Authors: Francesco Bove; Francesco Cavallieri; Anna Castrioto; Sara Meoni; Emmanuelle Schmitt; Amélie Bichon; Eugénie Lhommée; Pierre Pélissier; Andrea Kistner; Eric Chevrier; Eric Seigneuret; Stephan Chabardès; Franco Valzania; Valerie Fraix; Elena Moro Journal: Front Hum Neurosci Date: 2022-06-21 Impact factor: 3.473
Authors: Josiah Bennett; Jack MacGuire; Ena Novakovic; Huey Huynh; Keri Jones; Julian L Gendreau; Antonios Mammis; Mickey E Abraham Journal: Cureus Date: 2021-06-09