medRxiv (Cold Spring Harbor Laboratory),
Journal Year:
2024,
Volume and Issue:
unknown
Published: Dec. 28, 2024
Abstract
Deep
brain
stimulation
(DBS)
is
an
established
therapeutic
option
for
Parkinson
Disease
(PD),
with
demonstrated
efficacy
on
motor
symptoms
also
in
patients
carrying
GBA1
variants
(GBA-PD).
However,
it
was
recently
suggested
that
DBS
may
accelerate
cognitive
decline
this
frequent
genetic
subgroup,
raising
major
concerns
its
indication.
Primary
aim
of
study
to
investigate
the
possible
additive
effects
genotype
and
implant
deterioration
other
non-motor
features
long
term.
As
secondary
aims,
we
assessed
clinical
outcomes
DBS-GBA-PD
stratified
by
variant
classes
(severe/complex,
mild,
risk,
unknown),
different
targets
(subthalamic
nucleus
or
globus
pallidus).
This
a
multicenter
retrospective,
controlled,
Italian
cohort
involving
15
tertiary
level
Movement
Disorder
Centers
contributing
PARKNET
cohort.
Demographic,
motor,
were
collected
at
baseline
after
1,
3
5
years,
between
years
2005
2021.
We
selected
615
PD
participants
who
either
underwent
surgery
(430
DBS-nonGBA-PD
109
DBS-GBA-PD)
fulfilled
same
criteria
eligibility
but
eventually
not
operated
(76
nonDBS-GBA-PD).
Assessments
included
features,
as
well
long-term
complications,
across
all
groups
time
points.
Within-group
longitudinal
outcome
changes,
between-group
differences,
subgroups
analyses
performed.
At
baseline,
three
cohorts
largely
matched
demographic,
features.
Longitudinally,
both
showed
marked
improvements
quality
life,
benefit
which
absent
nonDBS-GBA-PD.
Cognitive
deterioration,
hallucinations
urinary
problems,
significantly
increased
GBA-PD
compared
nonGBA-PD,
regardless
DBS.
No
relevant
differences
emerged
upon
stratification
targets,
up
surgery.
represents
valid
GBA-PD,
generates
prolonged
benefits
life
while
modifying
occurrence
npj Parkinson s Disease,
Journal Year:
2024,
Volume and Issue:
10(1)
Published: June 8, 2024
Abstract
The
effects
of
subthalamic
nucleus
deep
brain
stimulation
(STN-DBS)
on
anxiety
in
Parkinson’s
disease
(PD)
are
understudied.
We
identified
clinical
predictors
STN-DBS
this
study.
In
prospective,
open-label,
multicentre
study,
we
assessed
patients
with
undergoing
for
PD
preoperatively
and
at
6-month
follow-up
postoperatively.
the
Hospital
Anxiety
Depression
Scale
(HADS-anxiety
depression
subscales),
Unified
Rating
Scale-motor
examination,
Scales
Outcomes
PD-motor
(SCOPA-M)-activities
daily
living
(ADL)
-motor
complications,
Non-Motor
Symptom
(NMSS),
PDQuestionnaire-8
(PDQ-8),
levodopa-equivalent
dose.
tested
changes
Wilcoxon
signed-rank
test
corrected
multiple
comparisons
(Bonferroni
method).
a
clinically
relevant
improvement
based
designated
threshold
½
standard
deviation
baseline
HADS-anxiety.
Moreover,
investigated
HADS-anxiety
correlations
linear
regressions.
included
50
(i.e.,
≥
8)
aged
63.1
years
±
8.3
10.4
4.5
duration.
improved
significantly
as
80%
our
cohort
experienced
improvement.
predictor
analyses,
worse
SCOPA-ADL
NMSS-urinary
domain
were
associated
greater
improvements.
PDQ-8
correlated
moderately.
Worse
preoperative
ADL
urinary
symptoms
predicted
favourable
postoperative
outcome,
which
turn
was
directly
proportionate
to
QoL
This
study
highlights
importance
detailed
assessments
alongside
other
non-motor
motor
when
advising
monitoring
PD.
Movement Disorders Clinical Practice,
Journal Year:
2025,
Volume and Issue:
unknown
Published: March 5, 2025
Deep
brain
stimulation
of
the
subthalamic
nucleus
(STN-DBS)
is
a
well-established
treatment
for
Parkinson's
Disease
(PD).
However,
long-term
trajectory
Quality
Life
(QoL)
following
STN-DBS
remains
underexplored.
We
aimed
to
conduct
systematic
review
and
meta-analysis
assess
QoL
trends
up
five
years
after
STN-DBS.
systematically
searched
PubMed,
Embase,
Cochrane
databases
from
inception
August
2024
studies
involving
PD
patients
treated
with
bilateral
STN-DBS,
evaluating
using
Questionnaire
(PDQ),
minimum
follow-up
12
months
post-surgery.
Continuous
outcomes
were
pooled
standardized
mean
differences
(SMD),
statistical
analyses
conducted
R
version
4.3.2.
Out
4106
screened
articles,
42
total
2767
included
in
meta-analysis.
improvements
observed
36
post-surgery
(SMD
0.83;
95%
CI
0.29
1.37),
followed
by
decline
pre-operative
levels
at
60
-0.06;
-0.26
0.15).
Subdomain
analysis
revealed
significant
deterioration
cognitive
function
communication.
Meta-regression
indicated
that
independent
clinical
sociodemographic
factors
such
as
age,
sex,
disease
duration;
however,
there
was
correlation
baseline
PDQ
(P
=
0.01).
This
provides
highlighting
further
need
explore
driving
develop
strategies
mitigate
this
deterioration.
Frontiers in Aging,
Journal Year:
2025,
Volume and Issue:
6
Published: March 25, 2025
Introduction:
We
performed
the
retrospective
study
to
investigate
relationship
between
preoperative
arterial
blood
lactate
level
and
postoperative
delirium
(POD)
in
Parkinson's
disease
(PD)
patients
undergoing
deep
brain
stimulation
(DBS)
surgery.
Methods:
Perioperative
data
of
DBS
surgery
under
total
intravenous
anesthesia
were
collected
study.
In
addition,
mini-mental
state
exam
score
for
assessing
cognitive
function
confusion
assessment
method
perioperative
PD
collected.
The
POD
was
analyzed
using
binary
logistic
regression
analysis.
Results:
A
156
included,
whom
29
(17.6%)
developed
POD.
Multivariable
analysis
showed
that
independently
associated
with
regarding
continuous
variable
[odds
ratio
(OR)
=
12.46,
95%
confidence
interval
(CI)=3.12–49.71,
P<0.001]
or
categorical
(OR=
3.58,
CI
=1.20–10.65,
P=0.022
lactate≥1.41).
Receiver
operating
characteristic
curve
a
significant
predictive
biomarker
POD,
an
area
0.708(95%CI=0.606–0.809,
P<0.05).
Subgroup
indicated
high
levels
independent
risk
factor
after
(OR=10.71,95%CI=1.17–97.87,
P=0.036)
female
patients.
Discussion:
Preoperative
is
disease.
Frontiers in Neuroscience,
Journal Year:
2025,
Volume and Issue:
19
Published: April 28, 2025
Objective
STN-DBS
is
an
effective
treatment
for
Parkinson’s
disease
(PD),
improving
motor
symptoms,
but
its
impact
on
non-motor
such
as
anxiety
and
depression,
remain
unclear.
This
study
investigates
the
relationship
between
electrode
contact
locations,
their
corresponding
volume
of
tissue
activated
(VTA),
postoperative
changes
in
emotional
symptoms.
It
aims
to
identify
optimal
group-level
stimulation
sites
depression
PD
patients
develop
a
structural
connectome
explore
how
cortical
regions
targeted
by
fiber
projections
correlate
with
mood
outcomes.
Methods
We
retrospectively
studied
56
who
underwent
bilateral
STN-DBS,
assessed
6
months
post-surgery.
Standardized
scales
evaluated
motor,
affective,
cognitive
symptoms
before
after
procedure.
Electrode
positions
were
reconstructed
using
Lead-DBS,
VTAs
calculated.
Voxel-wise
sweet
spot
connectivity
analyses
investigated
influenced
clinical
Results
Compared
preoperative
assessments,
evaluations
revealed
varying
degrees
improvement
function,
quality
life,
(
p
<
0.05).
The
amelioration
was
associated
contacts
located
ventral
region
STN.
Specifically,
improvements
positively
correlated
VTA
limbic
right
Sweet
analysis
that
ventrocentral
left
STN
significantly
improvement.
Structural
tracts
prefrontal
cortex
(PFC)
improvement,
while
those
sensorimotor
(SMC)
showed
negative
correlation.
Conclusion
markedly
improves
life
also
impacting
depressive
likely
target
ameliorating
therapeutic
effects
electrodes
may
promote
modulating
connected
regions.
Future
research
should
leverage
mapping
isolated
refine
placement,
directional
leads
specific
subregions
improved
symptom
management.
