Does deep brain stimulation for Parkinson's increase risk of dementia?


Date:
July 1, 2020
Source:
American Academy of Neurology
Summary:
There's good news for people with Parkinson's disease. A new study
shows that deep brain stimulation may not increase the risk of
developing dementia.



FULL STORY ========================================================================== There's good news for people with Parkinson's disease. A new study shows
that deep brain stimulation may not increase the risk of developing
dementia. The study is published in the July 1, 2020, online issue of Neurology(R), the medical journal of the American Academy of Neurology.


==========================================================================
For people with advanced Parkinson's disease, deep brain stimulation
has been shown to be more effective than medication in controlling their movement problems. But research has been mixed on whether the treatment
can increase the risk of developing dementia.

For deep brain stimulation, electrodes are placed in certain areas of
the brain to control abnormal movements. The electrodes are connected to
a device placed under the skin in the upper chest. The device controls
the electrical impulses.

"These results are very encouraging for people with Parkinson's and
their families that they can take advantage of the benefits of deep
brain stimulation without worrying about it increasing the likelihood
of developing dementia," said study author Elena Moro, MD, of Grenoble
Alpes University in Grenoble, France, and a Fellow of the American
Academy of Neurology.

The study involved 175 people with Parkinson's disease with an average
age of 56 who had deep brain stimulation. They had Parkinson's for an
average of 12 years when they had the stimulator implanted. Researchers
then checked the people after one year, five years and 10 years to see
how many people had developed dementia.

After one year, four people had developed dementia, or 2.3%. After five
years, 142 people were available for testing and 12 people had dementia,
or 8.5%. At 10 years, 104 people were still available for testing and
31 people had dementia, or 29.8%. The overall incidence rate was 35.6
per 1,000 person-years.

"These rates are not higher than those reported in the general population
of people with Parkinson's," said Moro. "The few studies that are
available with similar disease duration have reported higher rates
of dementia. Other studies of people with Parkinson's who are taking
medication for their symptoms show an incidence rate for dementia
that varies from 50 to 100 per 1,000 person-years." Moro said the
younger average age in her study may help explain the lower rate
of dementia. Also, people with moderate to severe memory or thinking
problems are not eligible to have deep brain stimulation, so the group
may have been less likely overall to develop dementia than a general
group of people with Parkinson's disease.

The study also looked at factors that were associated with a higher risk
of dementia. Researchers found that men, older people, people who had hallucinations, people with a low score on thinking tests before surgery,
and those who had a cerebral hemorrhage during the surgery to implant
the deep brain stimulator were more likely to develop dementia.

"Knowing these predictors may help us to select people who would respond
best to deep brain stimulation and who might have a greater risk of
having a poor cognitive outcome," Moro said.

A limitation of the study was that a high percentage of people did
not finish the study; researchers were not able to locate them or they
did not respond to requests from the researchers. This could result in underestimating the overall incidence of dementia.


========================================================================== Story Source: Materials provided by American_Academy_of_Neurology. Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Francesco Bove, Valerie Fraix, Francesco Cavallieri, Emmanuelle
Schmitt,
Euge'nie Lhomme'e, Ame'lie Bichon, Sara Meoni, Pierre Pe'lissier,
Andrea Kistner, Eric Chevrier, Claire Ardouin, Patricia Limousin,
Paul Krack, Alim Louis Benabid, Stephan Chabarde`s, Eric Seigneuret,
Anna Castrioto, Elena Moro. Dementia and subthalamic deep brain
stimulation in Parkinson disease A long-term overview. Neurology,
2020 DOI: 10.1212/ WNL.0000000000009822 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/07/200701162905.htm

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