Neuropsychological and social predictors of participation in a deep brain stimulation study of Parkinson’s disease and dystonia

Amelia Hahn , Ann A. Lazar , Stephanie Cernera , Simon Little , Sarah S. Wang , Philip A. Starr , Caroline A. Racine
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Abstract

Objectives

Participation is essential to DBS research, yet circumstances that affect diverse participation remain unclear. Here we evaluate factors impacting participation in an adaptive DBS study of Parkinson’s disease (PD) and dystonia.

Methods

Twenty participants were implanted with a sensing-enabled DBS device (Medtronic Summit RC+S) that allows neural data streaming in naturalistic settings and encouraged to stream as much as possible for the first five months after surgery. Using standardized baseline data obtained through neuropsychological evaluation, we compared neuropsychological and social variables to streaming hours.

Results

Marital status and irritability significantly impacted streaming hours (estimate=136.7, bootstrapped (b) CIb=45.0 to 249.0, pb=0.016, and estimate=−95.1, CIb=−159.9 to −49.2, pb=0.027, respectively). These variables remained significant after multivariable analysis. Composite scores on verbal memory evaluations predicted the number of hours of data streamed (R2=0.284, estimate=67.7, CIb=20.1 to 119.9, pb=0.019).

Discussion

Verbal memory impairment, irritability, and lack of a caregiver may be associated with decreased participation. Further study of factors that impact research participation is critical to the sustained inclusion of diverse participants.

参与帕金森病和肌张力障碍深部脑刺激研究的神经心理学和社会预测因素
目的参与对 DBS 研究至关重要,但影响不同参与的情况仍不清楚。在此,我们评估了影响参与帕金森病(PD)和肌张力障碍的适应性 DBS 研究的因素。方法 20 名参与者植入了可在自然环境中传输神经数据流的传感 DBS 设备(美敦力 Summit RC+S),并鼓励他们在术后前五个月尽可能多地传输数据流。通过神经心理评估获得的标准化基线数据,我们将神经心理和社会变量与流式治疗时长进行了比较。结果婚姻状况和易怒程度对流式治疗时长有显著影响(估计值=136.7,bootstrapped (b) CIb=45.0至249.0,pb=0.016;估计值=-95.1,CIb=-159.9至-49.2,pb=0.027)。这些变量在进行多变量分析后仍有意义。言语记忆评估的综合得分可预测数据流的小时数(R2=0.284,估计值=67.7,CIb=20.1 到 119.9,pb=0.019)。讨论言语记忆障碍、易怒和缺乏照顾者可能与参与度下降有关。进一步研究影响研究参与的因素对于持续纳入不同的参与者至关重要。
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