Association of preoperative visual hallucinations with cognitive decline after deep brain stimulation for parkinson’s disease

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

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Deep brain stimulation (DBS) is effective for the motor symptoms of Parkinson’s disease (PD). Although most patients benefit with minimal cognitive side effects, cognitive decline is a risk, and there is little available evidence to guide preoperative risk assessment. Visual illusions or visual hallucinations (VHs) and impulse-control behaviors (ICBs) are relatively common complications of PD and its treatment and may be a marker of more advanced disease, but their relationship with postoperative cognition has not been established. The authors aimed to determine whether any preoperative history of VHs or ICBs is associated with cognitive change after DBS. Methods: Retrospective chart review identified 54 patients with PD who received DBS of the subthalamic nucleus or globus pallidus internus and who completed both pre-and postoperative neuropsychological testing. Linear regression models were used to assess whether any preoperative history of VHs or ICBs was associated with changes in attention, executive function, language, memory, or visuospatial cognitive domains while controlling for surgical target and du-ration between evaluations. Results: The investigators found that a history of VHs was associated with declines in attention (b=-4.04, p=0.041) and executive function (b=-4.24, p=0.021). A history of ICBs was not associated with any significant changes. Conclusions: These results suggest that a history of VHs may increase risk of cognitive decline after DBS; thus, specific preoperative counseling and targeted remediation strategies for these patients may be indicated. In contrast, a history of ICBs does not appear to be associated with increased cognitive risk.

Original languageEnglish (US)
Pages (from-to)144-151
Number of pages8
JournalJournal of Neuropsychiatry and Clinical Neurosciences
Volume33
Issue number2
DOIs
StatePublished - Mar 1 2021
Externally publishedYes

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health

Fingerprint

Dive into the research topics of 'Association of preoperative visual hallucinations with cognitive decline after deep brain stimulation for parkinson’s disease'. Together they form a unique fingerprint.

Cite this