Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 May 13:16:867055.
doi: 10.3389/fnhum.2022.867055. eCollection 2022.

Cognitive Impact of Deep Brain Stimulation in Parkinson's Disease Patients: A Systematic Review

Valentino Rački  1   2 , Mario Hero  1   2 , Gloria Rožmarić  3 , Eliša Papić  1   2 , Marina Raguž  4   5 , Darko Chudy  4   6 , Vladimira Vuletić  1   2
Affiliations

Cognitive Impact of Deep Brain Stimulation in Parkinson's Disease Patients: A Systematic Review

Valentino Rački et al. Front Hum Neurosci. .

Abstract

Introduction: Parkinson'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.

Methods: We 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.

Results: Sixty-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.

Conclusion: Cognitive 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.

Keywords: Parkinson’s disease; cognition; cognitive outcome; deep brain stimulation; systematic review.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Prisma flow chart of the systematic review.
See this image and copyright information in PMC

References

    1. Acera M., Molano A., Tijero B., Bilbao G., Lambarri I., Villoria R., et al. (2019). Long-term impact of subthalamic stimulation on cognitive function in patients with advanced Parkinson’s disease. Neurología (Engl. Ed.) 34 573–581. 10.1016/j.nrleng.2017.05.008 - DOI - PubMed
    1. Armstrong M. J., Okun M. S. (2020). Diagnosis and treatment of Parkinson disease: a review. JAMA 323 548–560. 10.1001/jama.2019.22360 - DOI - PubMed
    1. Asahi T., Nakamichi N., Takaiwa A., Kashiwazaki D., Koh M., Dougu N., et al. (2014). Impact of bilateral subthalamic stimulation on motor/cognitive functions in Parkinson’s disease. Neurol. Med. Chir. (Tokyo) 54 529–536. 10.2176/nmc.oa.2013-0364 - DOI - PMC - PubMed
    1. Bloem B. R., Okun M. S., Klein C. (2021). Parkinson’s disease. Lancet 397 2284–2303. 10.1016/S0140-6736(21)00218-X - DOI - PubMed
    1. Boel J. A., Odekerken V. J. J., Schmand B. A., Geurtsen G. J., Cath D. C., Figee M., et al. (2016). Cognitive and psychiatric outcome 3 years after Globus pallidus pars Interna or subthalamic nucleus deep brain stimulation for Parkinson’s disease. Parkinsonism Relat. Disord. 33 90–95. 10.1016/j.parkreldis.2016.09.018 - DOI - PubMed

Publication types

LinkOut - more resources