JPD: Parkinson's disease, subcortical iron deposition predicts cognitive status after deep brain stimulation

Clinically, Parkinson's disease (PD) is characterized by motor symptoms (eg, tremor, stiffness, and bradykinesia), however, neuropsychological symptoms are increasingly recognized as a component of the disease
.

In clinical practice, most patients present with at least one neuropsychological (eg, cognitive and emotional) symptom, albeit at different stages and progressions of the disease course

As the disease progresses, people with Parkinson's disease continue to experience progressive motor (eg, motor fluctuations, levodopa-induced dyskinesia, gait disturbance, and falls) and non-motor (eg, cognitive, emotional, and autonomic) disabilities
.

Deep brain stimulation (DBS) has emerged as a well-established and effective surgical treatment for the motor symptoms of Parkinson's disease and is one of the most important therapeutic advances since the advent of dopaminergic therapy

Despite advances in exercise with DBS therapy, in 10-15% of patients, DBS is associated with neurophysiological decline, which may reduce QoL and the positive effects of DBS
.

Reports on the incidence of neuropsychological disorders following DBS treatment ranged from 0.
5% to 75%, with suspicion being underestimated and underreported

Here, Gregory Brown et al.

of Penn State-Hershey Medical Center investigated whether changes in brain iron are associated with neuropsychological outcomes in PD patients after DBS

method
.

Thirty-two PD subjects were identified from our database who underwent susceptibility MRI prior to bilateral subthalamic nucleus (STN) DBS

statistics

Combining clinical and MRI measures correlated better with neuropsychological outcomes (R2 ≥ 0.
373, P ≤ 0.
008) than either measure alone
.

Adding the R2∗ metric improved predictions for executive function (R2=0.
455, p=0.
008) and attention (R2=0.
182, p=0.
008), which were higher than the clinical metrics alone
.

Specifically, R2∗ for substantia nigra, caudate nucleus, STN, and hippocampus improved prediction of executive function
.

While R2∗ in putamen improves the prediction of attention

Specifically, R2∗ for substantia nigra, caudate nucleus, STN, and hippocampus improved prediction of executive function

The significance of the study lies in the discovery that patterns of brain iron accumulation, captured by susceptibility MRIs, predict neuropsychological outcomes after DBS in PD patients
.

Further studies are needed to validate these findings and to understand the region-specific corroboration of these findings and to understand the region-specific relationship between iron and DBS outcomes

Brain iron accumulation patterns captured by susceptibility MRI predict neuropsychological outcomes after DBS in PD patients

Original source:
Brown G, Du G, Farace E, et al.
Subcortical Iron Accumulation Pattern May Predict Neuropsychological Outcomes After Subthalamic Nucleus Deep Brain Stimulation: A Pilot Study.

Subcortical Iron Accumulation Pattern May Predict Neuropsychological Outcomes After Subthalamic Nucleus Deep Brain Stimulation: A Pilot Study.
Subcortical Iron Accumulation Pattern May Predict Neuropsychological Outcomes After Subthalamic Nucleus Deep Brain Stimulation: A Pilot Study.
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