Neuropsychological predictors of patient-reported cognitive decline after deep brain stimulation in Parkinson's disease.
Neuropsychological predictors of patient-reported cognitive decline after deep brain stimulation in Parkinson's disease.
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DOI：
10.1080/13803395.2018.1526889
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发表时间：
2019-04
影响因子：
2.2
通讯作者：
Brandt J
中科院分区：
文献类型：
--
作者：
Mills KA;Donohue K;Swaminathan A;Leoutsakos JM;Smith G;Brandt J
脑深部电刺激（DBS）可有效治疗帕金森病（PD）多巴胺能治疗的运动并发症，但偶尔与多领域认知功能下降相关。患者和患者报告的认知功能下降具有临床意义，并且在评估PD治疗干预措施时越来越被认为是重要的考虑因素。评估与PD患者和护理人员报告的DBS后两个或多个领域认知下降相关的术前神经心理学和临床因素。在DBS手术后1个月和4个月，使用单一电话调查评估患者和患者报告的5个领域的认知下降。两个或更多领域的下降被认为是多领域认知下降（MDCD）。基线人口统计学，临床和神经心理学因素进行了比较与MDCD或没有。术前神经心理学指标作为危险因素进行评估，并采用多元logistic回归分析，以人口统计学协变量对MDCD的存在进行回归分析。术前言语识别记忆、语言知识和言语处理能力下降与术后前四周患者报告的MDCD相关。DBS后4个月的MDCD与术前语言推理、语言回忆和语义语言流畅性较差相关。DBS后一个月，护理人员报告的MDCD与基线言语记忆识别准确性/辨别力、视觉空间问题解决和结构实践较差相关。手术前言语记忆识别、语言处理和视觉空间表现不佳与患者或护理人员报告的DBS手术后下降有关。后皮质功能障碍似乎预示着脑深部电刺激后自我报告的认知能力显著下降。
Deep brain stimulation (DBS) is effective for treatment of motor complications of dopaminergic therapy in Parkinson’s disease (PD) but occasionally has been associated with multi-domain cognitive decline. Patient- and caregiver-reported cognitive decline are clinically meaningful and increasingly recognized as important to consider when evaluating therapeutic interventions for PD. To assess presurgical neuropsychological and clinical factors associated with PD patient- and caregiver-reported cognitive decline in two or more domains after DBS. A single telephone survey was used to assess patient- and caregiver-reported cognitive decline in five domains at both one and four months after DBS surgery. Decline in two or more domains was considered multi-domain cognitive decline (MDCD). Baseline demographic, clinical, and neuropsychological factors were compared in those with or without MDCD. Preoperative neuropsychological measures were evaluated as risk factors and regressed on the presence of MDCD, with demographic covariates, using multiple logistic regression. Preoperative performance in verbal recognition memory, language knowledge, and verbal processing decline were associated with post-operative, patient-reported MDCD in the first four weeks. MDCD at four months after DBS was associated with worse preoperative verbal reasoning, verbal recall, and semantic verbal fluency. Caregiver-reported MDCD one month after DBS was associated with poorer baseline verbal memory recognition accuracy/discriminability, visuospatial problem solving, and constructional praxis. Poor presurgical performance in verbal memory recognition, language processing, and visuospatial performance are associated with patient- or caregiver-reported decline following DBS surgery. Posterior cortical dysfunction seems to portend significant self-reported cognitive decline following deep brain stimulation.
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影响因子：
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作者：
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通讯作者：
Jeon, Beom S.
影响因子：
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作者：
Lopez, Oscar L;Kuller, Lewis H
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作者：
Swainson, R;Rogers, RD;Robbins, TW
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Robbins, TW
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通讯作者：
Huang, Grant D.
影响因子：
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作者：
PILLON, B;DEWEER, B;DUBOIS, B
通讯作者：
DUBOIS, B