Does Quantitative Electroencephalography Refine Preoperative Cognitive Assessment in Parkinson’s Disease Patients Treated with Deep Brain Stimulation? A Follow-Up Study

Abstract

<b><i>Objective:</i></b> Deep brain stimulation (DBS) in Parkinson’s disease (PD) is associated with an increased risk of post-operative cognitive deterioration. Preoperative neuropsychological testing can be affected and limited by the patient’s collaboration in advanced disease. The purpose of this study was to determine whether preoperative quantitative electroencephalography (qEEG) may be a useful complementary examination technique during preoperative assessment to predict cognitive changes in PD patients treated with DBS. <b><i>Methods:</i></b> We compared the cognitive performance of 16 PD patients who underwent bilateral subthalamic nucleus DBS to the performance of 15 PD controls (matched for age, sex, and education) at baseline and at 24 months. Cognitive scores were calculated for all patients across 5 domains. A preoperative 256-channel resting EEG was recorded from each patient. We computed the global relative power spectra. Correlation and linear regression models were used to assess associations of preoperative EEG measures with post-operative cognitive scores. <b><i>Results:</i></b> Slow waves (relative delta and theta band power) were negatively correlated with post-operative cognitive performance, while faster waves (alpha 1) were strongly positively correlated with the same scores (the overall cognitive score, attention, and executive function). Linear models revealed an association of delta power with the overall cognitive score (<i>p</i> = 0.00409, adjusted <i>R</i><sup>2</sup> = 0.6341). Verbal fluency (VF) showed a significant decline after DBS surgery, which was correlated with qEEG measures. <b><i>Conclusions:</i></b> To analyse the side effects after DBS in PD patients, the most important parameter is verbal fluency capacity. In addition, correlation with EEG frequency bands might be useful to detect particularly vulnerable patients for cognitive impairment and be supportive in the selection process of patients considered for DBS.