Neuropsychological profile of Parkinson's disease patients selected for deep brain stimulation surgery

Abstract

BackgroundParkinson's disease (PD) shows symptoms involving motor and non-motor complications, including cognitive and behavioral changes, such changes might to contraindicate deep brain stimulation surgery (DBS).ObjectiveThe aim of study was to investigate the neuropsychological profile of patients with PD in a waiting list for DBS.MethodsThe neuropsychological evaluation was held in 30 patients of the ISCMPA Movement Disorders Clinic, with surgical indication based on the criteria of the responsible neurologists, in the period of 12 months. Instruments used: MMSE, FAB, MoCA, BDI, Semantic Verbal Fluency, PDQ-39, PDSS; and the UPDRS and Hoehn-Yahr scale.ResultsThe patients were mostly male (66.7%) with a mean age of 59.37 (SD 10.60) and disease duration 9.33 (SD 4.08). There was cognitive impairment in 56.7% of patients by FAB and 76.7% by MoCA.ConclusionEven in the earliest stages of the disease, there is the incidence of non-motor symptoms, especially in those subjects who had an early onset of the disease.

Diagnóstico e manejo da demência da doença de Parkinson e demência com corpos de Lewy: recomendações do Departamento Científico de Neurologia Cognitiva e do Envelhecimento da Academia Brasileira de Neurologia

“…A study applying a comprehensive neuropsychological battery showed cognitive impairment in 56.7% of PD patients in a waiting list for deep brain stimulation (DBS) implantation according to FAB scores and in 76.7% of them according to MoCA, showing the importance of a formal cognitive evaluation in this group of candidates to DBS 48 . Moreover, another study showed that the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) neuropsychological battery could effectively assess cognitive deficits in PD patients 49 .…”

“…Estudos anteriores em coortes brasileiras avaliaram o perfil cognitivo em pacientes com DP utilizando testes neuropsicológicos abrangentes e formais como a Escala de Mattis para avaliação de demência (MDRS), Scales for Outcomes of Parkinson's Disease-Cognition (SCOPA-COG), Teste Wisconsin de Classificação de Cartas (WCST), Bateria de Avaliação Frontal (FAB), Testes de Fluência Verbal 27,46 e o Trail Making Test 47 . Um estudo prévio que realizou uma bateria neuropsicológica abrangente em pacientes com DP em lista de espera para implantação de estimulação cerebral profunda (ECP) demonstrou comprometimento cognitivo em 56,7% da casuística através da FAB, e em 76,7% pelo MoCA, destacando a importância de uma avaliação cognitiva formal neste grupo específico de pacientes candidatos a tal procedimento 48 . Da mesma forma, um estudo anterior demonstrou que a bateria neuropsicológica do Consórcio para Estabelecer um Registro para a Doença de Alzheimer (CERAD) poderia ser eficiente para avaliar déficits cognitivos em pacientes com DP 49 .…”

Diagnosis and management of Parkinson’s disease dementia and dementia with Lewy bodies: recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology

“…Studies conducted in Brazil have assessed the cognitive profile of patients with PD using comprehensive and formal neuropsychological tests, such as the Mattis Dementia Rating Scale (MDRS), Scales for Outcomes in Parkinson's Disease-Cognition (SCOPA-COG), Wisconsin Card Sorting Test (WCST), Frontal Assessment Battery (FAB), Verbal Fluency Tests 27,46 , and Trail Making tests 47 . A study applying a comprehensive neuropsychological battery showed cognitive impairment in 56.7% of PD patients in a waiting list for deep brain stimulation (DBS) implantation according to FAB scores and in 76.7% of them according to MoCA, showing the importance of a formal cognitive evaluation in this group of candidates to DBS 48 . Moreover, another study showed that the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neuropsychological battery could effectively assess cognitive deficits in PD patients 49 .…”

Portal dos idosos: desenvolvimento de um ambiente virtual de aprendizagem sobre a doença de Parkinson e as alterações fonoaudiológicas

“…Parkinson, em que publicou um livro intitulado An EssayontheShaking Palsyem 1817, sendo a primeira descrição mundial bem definida da doença que consequentemente leva seu nome (PALERMO et al, 2009;TEIVE et al, 2017 (MACHADO et al, 2016;LANA et al, 2007).…”

“…Esta cirurgia reduz as complicações que acompanham os tratamentos dopaminérgicos, como flutuações motoras e discinesia. Para a recomendação da cirurgia para o indivíduo, é necessário que este tenha a doença há pelo menos cinco anos, não obtenha mais resultados com os tratamentos medicamentosos e não possua nenhuma alteração cognitiva grave (MACHADO et al, 2016).…”