Anatomical predictors of cognitive decline after subthalamic stimulation in Parkinson’s disease
Brain Struct Funct. 2018-05-07; 223(7): 3063-3072
DOI: 10.1007/s00429-018-1677-2
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Planche V(1), Munsch F(2), Pereira B(3), de Schlichting E(4), Vidal T(5), Coste J(4), Morand D(3), de Chazeron I(6), Derost P(7), Debilly B(7), Llorca PM(6), Lemaire JJ(4), Marques A(7), Durif F(7).
Author information:
(1)Service de Neurologie, CHU Clermont-Ferrand, Université Clermont Auvergne, 58 rue Montalembert, 63000, Clermont-Ferrand, France. .
(2)Service de Neuroradiologie diagnostique et thérapeutique, CHU Bordeaux, Université Bordeaux, 33000, Bordeaux, France.
(3)Unité de Biostatistiques, Direction à la Recherche Clinique et à l’Innovation (DRCI), CHU Clermont-Ferrand, 63000, Clermont-Ferrand, France.
(4)Service de Neurochirurgie, CHU Clermont-Ferrand, Centre National de la Recherche Scientifique (CNRS), Université Clermont Auvergne, 63000, Clermont-Ferrand, France.
(5)Centre Mémoire de Ressources et de Recherche (CMRR), CHU Clermont-Ferrand, 63000, Clermont-Ferrand, France.
(6)Centre Médico-Psychologique B (CMP-B), CHU Clermont-Ferrand, Université Clermont Auvergne, 63000, Clermont-Ferrand, France.
(7)Service de Neurologie, CHU Clermont-Ferrand, Université Clermont Auvergne, 58 rue Montalembert, 63000, Clermont-Ferrand, France.
We investigated whether pre-operative MRI measures of focal brain atrophy could
predict cognitive decline occurring after deep brain stimulation (DBS) of the
subthalamic nucleus (STN) in patients with Parkinson’s disease (PD). For that
purpose, we prospectively collected data of 42 consecutive patients with PD who
underwent bilateral STN-DBS. Normalized brain structure volumes and cortical
thicknesses were measured on pre-operative T1-weighted MRI. Patients were tested
for their cognitive performances before surgery and 1 year after. After
controlling for age, gender, pre-operative disease severity, change in
dopaminomimetic dose after surgery and contact location, we found correlations:
(1) between the variation of the total Mattis dementia rating scale (MDRS) score
and left lateral ventricle volume (p = 0.032), (2) between the variation of the
initiation/perseveration subscore of the MDRS and the left nucleus accumbens
volume (p = 0.042) and the left lateral ventricle volume (p = 0.017) and (3)
between the variation of the backward digit-span task and the right and left
superior frontal gyrus thickness (p = 0.004 and p = 0.007, respectively). Left
nucleus accumbens atrophy was associated with decline in the
initiation/perseveration subscore with the largest effect size (d = - 1.64).
Pre-operative left nucleus accumbens volume strongly predicted postoperative
decline in the initiation/attention subscore (AUC = 0.92, p