The microlesion effect is associated with global cognitive impairment and predicts motor outcomes after subthalamic deep brain stimulation in Parkinson's disease.
The microlesion effect is associated with global cognitive impairment and predicts motor outcomes after subthalamic deep brain stimulation in Parkinson's disease.
Where did the research take place?
The study site has not been established. Author addresses may differ from where the research occurred.
Nanchang, CN · Author affiliation
Department of Neurology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.Location evidence
Beijing, CN · Author affiliation
Beijing PINS Medical Co., Ltd., Beijing, China.Location evidence
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Original abstract
ObjectiveA postoperative microlesion effect (MLE) is regarded as a reliable predictor of the subsequent efficacy of deep brain stimulation of the subthalamic nucleus (STN-DBS) treatment. However, the predictive ability of MLE for postoperative motor improvement after DBS surgery in PD patients with global cognitive impairment (GCI) has not been fully explored.MethodsThis was a prospective, open-label, single-center study with a 6-month follow-up. Patients were divided into three groups based on the MLE response. After separately stratifying by MLE and by global cognitive impairment, we compared postoperative motor symptoms, as assessed by the MDS-UDPRS III, across these strata. To further investigate the impact of global cognitive impairment on long-term postoperative motor outcomes, a mediation analysis was conducted.ResultsThere were 18 patients (40%) classified as the Low MLE group, 19 patients (42.2%) as the Medium MLE group, and 8 patients (17.8%) as the High MLE group. Overall, the interaction effects of Group and Time (P = 0.008) were observed for changes in the MDS-UPDRS III score from baseline. The NC group exhibited a greater improvement compared to the GCI group. Global cognitive impairment was strongly associated with long-term postoperative motor outcomes (P = 0.002), with MLE serving as a mediator (indirect effect = - 0.10, P = 0.042).InterpretationIn summary, our study demonstrated that postoperative MLE is common and has strong predictive value for the efficacy of motor symptoms six months after STN-DBS. Additionally, MLE may partially mediate the detrimental effects on motor outcomes caused by global cognitive impairment.Trial registryCLINICALTRIALS.Gov identifierNCT06685510.