Cognitive decline represents a severe non-motor symptom of Parkinson's disease (PD) that can significantly reduce the benefits of subthalamic deep brain stimulation (STN DBS). Here, we aimed to describe post-surgery cognitive decline and identify pre-surgery cognitive profile associated with faster decline in STN DBS-treated PD patients. A retrospective observational study of 126 PD patients treated by STN DBS combined with oral dopaminergic therapy followed for 3.54 years on average (SD = 2.32) with repeated assessments of cognition was conducted. Pre-surgery cognitive profile was obtained via a comprehensive neuropsychological examination and data analysed using exploratory factor analysis and Bayesian generalized linear mixed models. On the whole, we observed a mild annual cognitive decline of 0.90 points from a total of 144 points in the Mattis Dementia Rating Scale (95% posterior probability interval [-1.19, -0.62]) with high inter-individual variability. However, true score changes did not reach previously reported reliable change cut-offs. Executive deficit was the only pre-surgery cognitive variable to reliably predict the rate of post-surgery cognitive decline. On the other hand, exploratory analysis of electrode localization did not yield any statistically clear results. Overall, our data and models imply mild gradual average annual post-surgery cognitive decline with high inter-individual variability in STN DBS-treated PD patients. Nonetheless, patients with worse long-term cognitive prognosis can be reliably identified via pre-surgery examination of executive functions. To further increase the utility of our results, we demonstrate how our models can help with disentangling true score changes from measurement error in future studies of post-surgery cognitive changes.
- MeSH
- hluboká mozková stimulace * metody MeSH
- kognice fyziologie MeSH
- kognitivní dysfunkce * etiologie terapie patofyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- neuropsychologické testy MeSH
- nucleus subthalamicus * MeSH
- Parkinsonova nemoc * terapie patofyziologie MeSH
- retrospektivní studie MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
Objectives: To characterize the inclusion of cognition in definitions of successful aging (SA) according to empirical studies published in peer-reviewed journals.Methods: A systematic review across ISI Web of Knowledge.Results: Of the 74 included studies, there were 65 studies (87.8%) analyzing cognition as one component of multicomponent SA model (cognitive component studies), and 9 studies (12.2%) focusing solely on successful cognitive aging (SCA studies). Most of the studies operationalized cognition in SA by defining SA group and analyzing single SA indicators. A minority of the studies calculated the SA index. Finally, emergent techniques to operationalize SA as a latent variable and emergent field of cognition in SA in pathology were identified.Conclusions: The results highlight that cognition is being included in SA using different levels of complexity. Even though research investigating SA in pathology is emerging, there is currently a lack of utilization of the concept in pathological and at-risk populations.Clinical implications: The current research of cognition in SA provides several valid options to evaluate if a person is aging successfully. The emerging research indicates that people from at-risk and pathological populations can age successfully.
- MeSH
- kognice * MeSH
- kognitivní stárnutí * MeSH
- lidé MeSH
- stárnutí psychologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- systematický přehled MeSH
BACKGROUND: Acute methanol poisoning leads to optic neuropathy and necrotic lesions of basal ganglia (BG) and subcortical white matter. Survivors of methanol poisoning exhibit long-term executive and memory deficits. Associations between brain volumetry parameters and cognitive sequelae of methanol poisoning are not known. The aim of our study was to identify long-term associations between the cognitive performance of survivors of methanol poisoning and the volume of the brain structures that are selectively vulnerable to methanol. METHODS: We conducted a cross-sectional follow-up study on a sample of patients (n = 33, age 50 ± 14 years, 82% males) who survived acute methanol poisoning during methanol mass poisoning outbreak from September 2012 till January 2013 in the Czech Republic. A battery of neuropsychological tests and brain magnetic resonance imaging were included in the clinical examination protocol. Specific brain structures (putamen, globus pallidus, nucleus caudatus, and frontal white matter) were selected as regions of interest, and their volumes were estimated using the MorphoBox prototype software. RESULTS: In robust multiple regression models, sustained visual attention performance (as assessed by Trail Making Test and Prague Stroop Test) was positively associated with BG structures and frontal white matter volumes (Wald = 9.03 to 85.50, p < 0.01), sensitivity to interference (as assessed by Frontal Battery Assessment) was negatively associated with frontal white matter volume (Wald = 35.44 to 42.25, p < 0.001), and motor performance (as assessed by Finger Tapping Test) was positively associated with globus pallidus and frontal white matter volumes (Wald = 9.66 to 13.29, p < 0.01). CONCLUSIONS: Our results demonstrate that smaller volumes of elements of BG-thalamocortical circuitry, namely the BG and frontal white matter, relate to attention and motor performance in methanol poisoning from a long-term perspective. Disruption of those functional circuits may underlie specific cognitive deficits observed in methanol poisoning.
- MeSH
- bazální ganglia diagnostické zobrazování MeSH
- bílá hmota diagnostické zobrazování MeSH
- dospělí MeSH
- exekutivní funkce účinky léků MeSH
- kognice účinky léků MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- methanol otrava MeSH
- mozek diagnostické zobrazování MeSH
- následné studie MeSH
- nervová síť diagnostické zobrazování MeSH
- neuropsychologické testy MeSH
- paměť účinky léků MeSH
- pozornost účinky léků MeSH
- přežívající MeSH
- průřezové studie MeSH
- psychomotorický výkon účinky léků MeSH
- senioři MeSH
- učení účinky léků MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
