title: Deep brain stimulation and cognitive decline in Parkinson's disease: The predictive value of electroencephalography.
abstract: Some Parkinson's disease (PD) patients treated with subthalamic nucleus deep brain stimulation (STN-DBS) develop new-onset cognitive decline. We examined whether clinical EEG recordings can be used to predict cognitive deterioration in PD patients undergoing STN-DBS. In this retrospective study, we used the Grand Total EEG (GTE)-score (short and total) to evaluate pre- and postoperative EEGs. In PD patients undergoing STN-DBS (N = 30), cognitive functioning was measured using Mini-Mental State Test and DemTect before and after surgery. Severity of motor impairment was assessed using the Unified Parkinson's Disease Rating Scale-III. Patients were classified into patients with or without cognitive decline after STN-DBS surgery. Epidemiological data, pre- and postoperative EEG recordings as well as neuropsychological and neurological data, electrode positions and the third ventricle width were compared. A logistic regression model was used to identify predictors of cognitive decline. Motor deficits significantly improved from pre- to post-surgery, while the mean GTE-scores increased significantly. Six patients developed cognitive deterioration 4-12 months postoperatively. These patients had significantly higher preoperative GTE-scores than patients without cognitive deterioration, although preoperative cognitive functioning was comparable. Electrode positions, brain atrophy and neurological data did not differ between groups. Logistic regression analysis identified the GTE-score as a significant predictor of postoperative cognitive deterioration. Data suggest that the preoperative GTE-score can be used to identify PD patients that are at high risk for developing cognitive deterioration after STN-DBS surgery even though their preoperative cognitive state was normal.
authors.affiliation: Department of Neurology, University Hospital of Cologne, Kerpener Str. 62, 50924, Cologne, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Markser
authors.affiliation: Department of Neurology, University Hospital of Cologne, Kerpener Str. 62, 50924, Cologne, Germany. franziska.maier@uk-koeln.de.
authors.forename: Franziska
authors.initials: F
authors.lastname: Maier
authors.affiliation: Department of Neurology, University Hospital of Cologne, Kerpener Str. 62, 50924, Cologne, Germany.
authors.forename: C J
authors.initials: CJ
authors.lastname: Lewis
authors.affiliation: Department of Neurology, University Hospital of Cologne, Kerpener Str. 62, 50924, Cologne, Germany.
authors.forename: T A
authors.initials: TA
authors.lastname: Dembek
authors.affiliation: Department of Neurology, University Hospital of Cologne, Kerpener Str. 62, 50924, Cologne, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Pedrosa
authors.affiliation: Department of Neurology, University Hospital of Cologne, Kerpener Str. 62, 50924, Cologne, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Eggers
authors.affiliation: Department of Neurology, University Hospital of Cologne, Kerpener Str. 62, 50924, Cologne, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Timmermann
authors.affiliation: Department of Neurology, University Hospital of Cologne, Kerpener Str. 62, 50924, Cologne, Germany.|Institute of Gerontology, Psychological Gerontology and Center for Neuropsychological Diagnostics and Intervention, University of Vechta, Vechta, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Kalbe
authors.affiliation: Department of Neurology, University Hospital of Cologne, Kerpener Str. 62, 50924, Cologne, Germany.|Institute of Neuroscience and Medicine (INM-3), Cognitive Neuroscience, Research Centre Juelich, Juelich, Germany.
authors.forename: G R
authors.initials: GR
authors.lastname: Fink
authors.affiliation: Department of Neurology, University Hospital of Cologne, Kerpener Str. 62, 50924, Cologne, Germany.
authors.forename: Lothar
authors.initials: L
authors.lastname: Burghaus
mesh_terms: D000368:Aged; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D046690:Deep Brain Stimulation / Q000009:adverse effects*; D004567:Electrodes, Implanted / Q000009:adverse effects*; D004569:Electroencephalography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010300:Parkinson Disease / Q000503:physiopathology* / Q000628:therapy; D011237:Predictive Value of Tests; D011379:Prognosis; D020531:Subthalamic Nucleus / Q000601:surgery
keywords: Cognitive decline; Deep brain stimulation; Dementia; Electroencephalogram; Grand total EEG score; Parkinson’s disease