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    Home > Active Ingredient News > Study of Nervous System > Annals of Neurology: Does Parkinson's suffer from deep brain stimulation, impaired glucose metabolism, and whether it affects cognitive function

    Annals of Neurology: Does Parkinson's suffer from deep brain stimulation, impaired glucose metabolism, and whether it affects cognitive function

    • Last Update: 2022-03-04
    • Source: Internet
    • Author: User
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    Parkinson's disease (PD) affects at least 1 million people in the United States,1 and approximately 9000 PD patients each year choose to have a deep brain stimulator (DBS) implanted in the subthalamic nucleus (STN)
    .

    PD patients with mutations in the glucocerebrosidase (GBA) gene (PD-GBA) are of particular concern because of their increased risk of cognitive impairment
    .


    PD-GBA subjects had reduced glucocerebrosidase (GCase) activity, leading to disturbances in sphingomyelin metabolism and faster accumulation and spread of Lewy body lesions compared with non-mutation carriers


    PD-GBA is associated with early onset of the disease, so these individuals may be more inclined to pursue DBS
    .


    Up to 17% of PD subjects receiving DBS carry GBA variants



    Given the compact anatomy of the STN, it is possible that unexpected currents spread to adjacent associative and marginal subregions, adjacent fiber bundles, or other adjacent nuclei, such as the substantia nigra
    .


    Furthermore, a recent pilot study found differences in beta power between PDGBA and non-GBA subjects, suggesting that genotype may be associated with specific neurophysiological changes



    They leveraged clinical and genetic data from 12 datasets
    .


    Global cognitive ability was assessed using the Mattis Dementia Rating Scale (MDRS)


    Data were available for 366 subjects (58 GBA+DBS+, 82 GBA+DBS-, 98 GBA-DBS+, 128 GBA-DBS- subjects) who were tracked longitudinally (range = postoperative 36-60 months)
    .


    Using MDRS, GBA+DBS+ subjects had a mean decrease of 2.
    02 points/year (95% confidence interval [CI] = -2.


    The significance of this study lies in its findings: The combined effects of GBA mutations and STN-DBS have a negative impact on cognition
    .


    GBA mutation screening for DBS as part of the preoperative decision-making process


    Combined effects of GBA mutations and STN-DBS negatively impact cognitive screening


    Original source:
    Pal G, Mangone G, Hill EJ, et al.


    Parkinson Disease and Subthalamic Nucleus Deep Brain Stimulation: Cognitive Effects in GBA Mutation Carriers.
    Annals of Neurology.


    Parkinson Disease and Subthalamic Nucleus Deep Brain Stimulation: Cognitive Effects in GBA Mutation Carriers.

     

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