Regression-based thresholds to detect clinical changes in verbal fluency after STN-DBS in Parkinson's disease

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY Parkinsonism & related disorders Pub Date : 2025-01-31 DOI:10.1016/j.parkreldis.2025.107300

Francesca Mameli , Edoardo Nicolò Aiello , Fabiana Ruggiero , Eleonora Zirone , Linda Borellini , Filippo Cogiamanian , Angelica Marfoli , Federica Solca , Barbara Poletti , Nicola Ticozzi , Sergio Barbieri , Alberto Priori , Roberta Ferrucci

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Abstract

Introduction

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) improves motor functions in patients with Parkinson's disease (PD) but may cause a decline in specific cognitive domains including executive processes and language.

The aim of this study was to derive standardized regression-based (SRB) reliable change indices (RCIs) in an Italian cohort of Parkinson's patients undergoing STN-DBS to detect clinically meaningful variations in verbal fluency (VF) one year after surgery define.

Methods

Before (T0) and 12 months after (T1) surgery, 36 PD patients who underwent bilateral STN-DBS were evaluated with the Alternate Verbal Fluency Battery (AVFB), including phonemic (PVF), semantic (SVF) and alternate VF tests (AVF) and a composite shifting index (CSI). At T0, motor status was assessed using the Unified Parkinson's Disease Rating Scale-III (UPDRS-III) and L-dopa equivalent daily dose was recorded.

Results

Group-level declines were limited to PVF and SVF scores. Applications of these RCIs revealed idiosyncratic patterns of longitudinal trends that differed from those at the group level. Indeed, when looking at individual performances, no clustered pattern of decline or improvement could be visibly detected. The UPDRS-III predicted T1 AVF and CSI scores.

Conclusion

Our study provides Italian practitioners and researchers with SRB-RCIs to detect meaningful differences in the VF performance of PD patients undergoing STN-DBS one year after surgery. Variables associated with postoperative cognitive changes can be used in future studies to develop multivariable predictive models to support clinical decision making and patient counselling.

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基于回归的阈值检测帕金森病STN-DBS后语言流畅性的临床变化

丘脑下核（STN）的深部脑刺激（DBS）改善帕金森病（PD）患者的运动功能，但可能导致特定认知领域（包括执行过程和语言）的下降。本研究的目的是在意大利接受STN-DBS的帕金森患者队列中获得基于标准化回归（SRB）的可靠变化指数（rci），以检测手术后一年语言流畅性（VF）的临床有意义的变化。方法对36例行双侧STN-DBS手术的PD患者在手术前（T0）和手术后（T1） 12个月进行替代言语流畅性测试（AVFB），包括音位测试（PVF）、语义测试（SVF）、替代言语流畅性测试（AVF）和复合移位指数（CSI）。在T0时，使用统一帕金森病评定量表- iii （UPDRS-III）评估运动状态，并记录左旋多巴当量日剂量。结果组水平的下降仅限于PVF和SVF评分。这些rci的应用揭示了与群体水平不同的纵向趋势的特殊模式。事实上，当观察个人表现时，没有明显的下降或提高的集群模式。UPDRS-III预测T1 AVF和CSI评分。结论我们的研究为意大利的医生和研究人员提供了srb - rci，以检测PD患者术后一年接受STN-DBS的VF表现的有意义的差异。与术后认知变化相关的变量可以在未来的研究中用于开发多变量预测模型，以支持临床决策和患者咨询。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Parkinsonism & related disorders 医学-临床神经学

CiteScore

6.20

自引率

4.90%

发文量

292

审稿时长

39 days

期刊介绍： Parkinsonism & Related Disorders publishes the results of basic and clinical research contributing to the understanding, diagnosis and treatment of all neurodegenerative syndromes in which Parkinsonism, Essential Tremor or related movement disorders may be a feature. Regular features will include: Review Articles, Point of View articles, Full-length Articles, Short Communications, Case Reports and Letter to the Editor.