IntroductionParkinson’s disease (PD) patients have a significantly higher risk of developing dementia in later disease stages, leading to severe impairments in quality of life and self-functioning. Questions remain on how deep brain stimulation (DBS) affects cognition, and whether we can individualize therapy and reduce the risk for adverse cognitive effects. Our aim in this systematic review is to assess the current knowledge in the field and determine if the findings could influence clinical practice.MethodsWe have conducted a systematic review according to PRISMA guidelines through MEDLINE and Embase databases, with studies being selected for inclusion via a set inclusion and exclusion criteria.ResultsSixty-seven studies were included in this systematic review according to the selected criteria. This includes 6 meta-analyses, 18 randomized controlled trials, 17 controlled clinical trials, and 26 observational studies with no control arms. The total number of PD patients encompassed in the studies cited in this review is 3677, not including the meta-analyses.ConclusionCognitive function in PD patients can deteriorate, in most cases mildly, but still impactful to the quality of life. The strongest evidence is present for deterioration in verbal fluency, while inconclusive evidence is still present for executive function, memory, attention and processing speed. Global cognition does not appear to be significantly impacted by DBS, especially if cognitive screening is performed prior to the procedure, as lower baseline cognitive function is connected to poor outcomes. Further randomized controlled studies are required to increase the level of evidence, especially in the case of globus pallidus internus DBS, pedunculopontine nucleus DBS, and the ventral intermediate nucleus of thalamus DBS, and more long-term studies are required for all respective targets.

Aim To assess the effect of social isolation due to the coronavirus disease 2019 (COVID-19) pandemic on physical and mental health of Parkinson’s disease patients treated at the University Hospital Center Rijeka. Methods This cross-sectional telephone study involved Parkinson’s disease patients who had at least one control examination at University Hospital Center Rijeka in 2020 and were Croatian citizens. A questionnaire was used to obtain data on the socio-demographic characteristics and the severity of motor, anxiety, depression, and non-motor symptoms. Results The final sample included 87 patients. Most patients reported subjective worsening of motor symptoms. Patients who lived alone had worse motor scores than those not living alone. The majority of patients reported worsening of anxiety symptoms. Significant worsening of anxiety symptoms was found in patients who lived alone, had a longer disease duration, and had avoided check-ups. Fewer patients had depression symptoms than motor and anxiety symptoms. Significantly higher Hamilton Depression Rating Scale scores were observed in patients with a longer disease duration. Significant worsening of non-motor symptoms was identified in patients who lived alone, were less educated, had a longer disease duration, and had a higher Charlson comorbidity index. Conclusion Patients who live alone, have longer disease duration, are less educated, avoid check-ups, and have more comorbidities are more vulnerable to the negative effects of social isolation.

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Dystonia is a movement disorder characterized by sustained or intermittent muscle contractions, leading to abnormal involuntary movements or postures. Although the pathogenesis of dystonia is not entirely understood, lack of intracortical inhibition, aberrant sensory integration and derangement of neural plasticity are known to contribute. Etiologically, dystonia can be idiopathic, acquired or hereditary, most commonly occurring with TOR1A, THAP1, GCH1, and KMT2B mutations. e classi cation of dystonia is based on two main axes: clinical features (Axis I) and etiology (Axis II). When it comes to treatment a variety of therapeutic options are available, including oral medication therapy, intramuscular injections of botulinum neurotoxins (BoNTs), physical and occupational therapy and invasive neurosurgical treatment. Deep brain stimulation (DBS) is an established neurosurgical treatment for medication-refractory dystonia. As more evidence suggests that DBS treatment outcomes may be related to a hereditary basis, genotype determination is an important factor to consider in patient selection and prognostic counselling.

Duboka mozgovna stimulacija (DBS) vodeća je kirurška metoda u liječenju bolesnika s uznapredovanom Parkinsonovom bolešću (PD). Neurorehabilitacijom nakon ugradnje DBS uređaja nastoji se oboljelima omogućiti normalno funkcioniranje u svakodnevnim interakcijama i aktivnostima te na taj način unaprijediti kvalitetu života. U procesu neurorehabilitacije sudjeluje multidisciplinarni tim koji čine neurolog, fizioterapeut i logoped. Uloga neurologa u ovome procesu je prilagođavanje parametara DBS uređaja te prilagodba farmakološke terapije. Uloga fizioterapeuta je održavanje i obnavljanje maksimalne funkcionalne pokretljivosti i sposobnosti, dok je uloga logopeda terapija poremećaja govora na koji DBS ima specifičan utjecaj.