Association of Preoperative Visual Hallucinations With Cognitive Decline After Deep Brain Stimulation for Parkinson’s Disease

Kratter, Ian H.; Karp, Jordan F.; Chang, Yue‐Fang; Whiteman, Ashley C.; Feyder, Michael T.; Jorge, Ahmed; Richardson, R. Mark; Henry, Luke C.

doi:10.1176/appi.neuropsych.20040077

Cited by 3 publications

(4 citation statements)

References 39 publications

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“…However, there are also rare cases of psychotic adverse events for DBS, LCIG, and CAI but also in the BMT groups 15,22,24,34 . VHs are further reported to be a risk factor for cognitive decline after DBS 95 . These findings highlight the difficulty in differentiating between disease‐ and invention‐induced psychotic symptoms.…”

Section: Resultsmentioning

confidence: 96%

“…Adverse events are outlined in part 1. As VH predicts a cognitive decline in PD patients even after DBS treatment, pretesting the cognitive status is obligatory for any invasive treatment option 85,95 . A reduced cognitive status is associated with a limited ability for device management in pump therapies 98,99 .…”

Section: Resultsmentioning

confidence: 99%

“… 15 , 22 , 24 , 34 VHs are further reported to be a risk factor for cognitive decline after DBS. 95 These findings highlight the difficulty in differentiating between disease‐ and invention‐induced psychotic symptoms.…”

Section: Resultsmentioning

confidence: 99%

“…As VH predicts a cognitive decline in PD patients even after DBS treatment, pretesting the cognitive status is obligatory for any invasive treatment option. 85 , 95 A reduced cognitive status is associated with a limited ability for device management in pump therapies. 98 , 99 Therefore, the prospective disability must be considered in patients with VH, and invasive treatment options might be restricted in the case of nonexistence of care partners.…”

Section: Resultsmentioning

confidence: 99%

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How to Use the New European Academy of Neurology/Movement Disorder Society European Section Guideline for Invasive Therapies in Parkinson's Disease

Brinker,

Smilowska,

Paschen

et al. 2024

Movement Disord Clin Pract

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BackgroundThe decision to choose invasive treatments for Parkinson's disease (PD) is complex and needs careful consideration.ObjektivesAlthough the recommendations of the EAN/MDS‐ES guideline for invasive therapies of PD are useful, the different clinical profiles of people with PD who seek advice for possible invasive therapy need further attention.Methods and ResultsHere we describe eight clinical standard situations of people with PD unsatisfied with their current oral treatment where invasive therapies may be considered. These are PD patients presenting with (1) severe motor fluctuations, (2) beginning of levodopa‐responsive fluctuations, severe tremor at (3) young or (4) advanced age, (5) impulse control disorders and related behavioural disorders, (6) hallucinations and psychosis, (7) minimal cognitive impairment or mild dementia and (8) patients in palliative care need. For some of these conditions evidence at lower level or simple clinical considerations exist.ConclusionsThere are no one‐fits‐all answers, but physician and patient should discuss each option carefully considering symptom profile, psychosocial context, availability of therapy alternatives, and many other factors. The current paper outlines our proposed approach to these circumstances.This article is protected by copyright. All rights reserved.

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Section: Resultsmentioning

confidence: 96%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

How to Use the New European Academy of Neurology/Movement Disorder Society European Section Guideline for Invasive Therapies in Parkinson's Disease

Brinker,

Smilowska,

Paschen

et al. 2024

Movement Disord Clin Pract

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Depression history modulates effects of subthalamic nucleus topography on neuropsychological outcomes of deep brain stimulation for Parkinson’s disease

et al. 2022

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Patients with psychiatric symptoms, such as depression, anxiety, and visual hallucinations, may be at increased risk for adverse effects following deep brain stimulation of the subthalamic nucleus for Parkinson’s disease, but there have been relatively few studies of associations between locations of chronic stimulation and neuropsychological outcomes. We sought to determine whether psychiatric history modulates associations between stimulation location within the subthalamic nucleus and postoperative affective and cognitive changes. We retrospectively identified 42 patients with Parkinson’s disease who received bilateral subthalamic nucleus deep brain stimulation and who completed both pre- and postoperative neuropsychological testing. Active stimulation contacts were localized in MNI space using Lead-DBS software. Linear discriminant analysis identified vectors maximizing variance in postoperative neuropsychological changes, and Pearson’s correlations were used to assess for linear relationships. Stimulation location was associated with postoperative change for only 3 of the 18 neuropsychological measures. Variation along the superioinferior (z) axis was most influential. Constraining the analysis to patients with a history of depression revealed 10 measures significantly associated with active contact location, primarily related to location along the anterioposterior (y) axis and with worse outcomes associated with more anterior stimulation. Analysis of patients with a history of anxiety revealed 5 measures with location-associated changes without a predominant axis. History of visual hallucinations was not associated with significant findings. Our results suggest that a history of depression may influence the relationship between active contact location and neuropsychological outcomes following subthalamic nucleus deep brain stimulation. These patients may be more sensitive to off-target (nonmotor) stimulation.

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Developments in the prediction of cognitive changes following deep brain stimulation in persons with Parkinson’s disease

Tröster

2024

Expert Review of Neurotherapeutics

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Association of Preoperative Visual Hallucinations With Cognitive Decline After Deep Brain Stimulation for Parkinson’s Disease

Cited by 3 publications

References 39 publications

How to Use the New European Academy of Neurology/Movement Disorder Society European Section Guideline for Invasive Therapies in Parkinson's Disease

How to Use the New European Academy of Neurology/Movement Disorder Society European Section Guideline for Invasive Therapies in Parkinson's Disease

Depression history modulates effects of subthalamic nucleus topography on neuropsychological outcomes of deep brain stimulation for Parkinson’s disease

Developments in the prediction of cognitive changes following deep brain stimulation in persons with Parkinson’s disease

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