Clinical Parkinsonism Related Disorders最新文献

{"title":"Comparison of clinical measures of motor function with a Holter monitor in Parkinson’s disease","authors":"Carlos Pérez-López ,&nbsp;Nuria Caballol ,&nbsp;Mariateresa Buongiorno ,&nbsp;María Asunción Ávila Rivera ,&nbsp;Núria López Ariztegui ,&nbsp;Lydia López-Manzanares ,&nbsp;Jorge Hernández-Vara ,&nbsp;Àngels Bayes Rusiñol ,&nbsp;Alexandre Gironell Carreró ,&nbsp;María Álvarez Saúco ,&nbsp;Elisabet Franquet Gomez ,&nbsp;David A Pérez-Martínez ,&nbsp;Sonia Escalante Arroyo ,&nbsp;Silvia Martí Martínez ,&nbsp;Pablo Mir ,&nbsp;José Mª Salom Juan ,&nbsp;Juan Carlos Martínez-Castrillo ,&nbsp;Alejandro Rodríguez-Molinero","doi":"10.1016/j.prdoa.2025.100325","DOIUrl":"10.1016/j.prdoa.2025.100325","url":null,"abstract":"<div><h3>Background</h3><div>Parkinson’s disease (PD) is a significant global health challenge, affecting millions worldwide. This sub-study aims to explore the potential of ambulatory monitoring devices in identifying disease severity and progression in patients. As part of the MOMOPA-EC clinical trial, 156 patients with moderate to severe PD underwent 435 assessments using clinical scales and ambulatory monitoring devices (Parkinson’s Holter). This sub-study seeks to establish relations between parameters derived from Holter monitors and clinical severity measures to enhance personalized disease management strategies. Methods: In the MOMOPA-EC trial, 435 patient monitoring sessions were conducted, during which patients wore Parkinson’s Holter monitors for a week before completing clinical assessments, including the Unified Parkinson’s Disease Rating Scale (UPDRS), Parkinson’s Disease Questionnaire (PDQ-39), and Freezing of Gait Questionnaire (FoG-Q). Results: The reports obtained during the monitoring of the patients were classified into three groups based on the greater or lesser gait fluidity (according to the measurements from the Parkinson’s Holter). All clinical scales were significantly different in each of these groups, indicating that patients with lower stride fluidity had poorer outcomes across the different clinical scales. Conclusions: The findings of this study underscore the potential of Parkinson’s Holters in providing objective data for personalized disease management in PD patients. Integrating such technologies into routine clinical practice could enhance patient care and treatment strategies by offering clinicians objective insights into both disease progression and therapeutic response.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100325"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143851984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective database analysis on the demographics and resource utilization of patients with Parkinson’s disease in Quebec, Canada","authors":"Véronique Baribeau ,&nbsp;Shawn Mohammed ,&nbsp;Amnah Awan ,&nbsp;Diana Parison ,&nbsp;Jean Lachaine","doi":"10.1016/j.prdoa.2025.100300","DOIUrl":"10.1016/j.prdoa.2025.100300","url":null,"abstract":"<div><h3>Introduction</h3><div>Parkinson’s disease (PD) is the most prevalent neurodegenerative movement disorder. Despite its recognized significance, there remains a paucity of recent studies reporting treatment utilization and the economic impact of PD in a real-world setting, especially in Canada. This study aimed to analyze real-world treatment patterns and health care resource utilization (HCRU) of patients with PD in Quebec, Canada.</div></div><div><h3>Methods</h3><div>This was a retrospective observational study using data between 2010–2019 from the Régie de l’assurance maladie du Québec (RAMQ) databases. Patients with PD were compared to age- and sex-matched controls. Treatment adherence and persistence were measured over 24 months. All-cause and PD-related HCRU and costs were characterized on an annual basis.</div></div><div><h3>Results</h3><div>Overall, 303 PD patients and 909 age- and sex-matched controls were selected. Adherence rates were high (≥85 %) among all drug classes, but lower with dopamine agonists. Persistence to PD treatment declined over time, with nearly 50 % discontinuation rates at 24 months in all PD drug classes, except the levodopa class (discontinuation rate: 20.4 %). PD patients had a significantly higher total costs per year than the matched control group ($17,405 vs. $6,431), mainly driven by higher inpatient costs.</div></div><div><h3>Conclusion</h3><div>Many pharmacological options exist for PD patients and, though patients are adherent while on therapy, treatment discontinuation rates are high. This suggests potential long-term challenges in PD management, especially since PD continues to place a substantial burden on the health care system. This study underscores the need for enhanced therapeutic strategies, particularly for patients inadequately controlled with standard therapies.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100300"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143176206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An unusual presentation of Huntington’s disease-like syndrome in a patient with Xeroderma pigmentosum type F: Case report and review of the literature","authors":"Nicolas De Cleene ,&nbsp;Federico Carbone ,&nbsp;Clancy Cerejo ,&nbsp;Marina Peball ,&nbsp;Franco Stanzial ,&nbsp;Francesco Benedicenti ,&nbsp;Renate Lunzer ,&nbsp;Klaus Seppi ,&nbsp;Beatrice Heim","doi":"10.1016/j.prdoa.2025.100340","DOIUrl":"10.1016/j.prdoa.2025.100340","url":null,"abstract":"<div><h3>Background</h3><div>Xeroderma pigmentosum (XP) is a rare genetic disease in which the Nucleotide Excision Repair (NER) system is affected, resulting in defective DNA-repair. Clinical features are UV-light hypersensitivity with erythema, corneal lesions, and increased risk for skin cancers. Around 20% of affected individuals develop neurological manifestations like movement disorders due to neurodegeneration.</div></div><div><h3>Case</h3><div>We report a 33-year-old man, presenting with mild choreatic movements of the lower face and limbs, executive dysfunction and mild atactic features. Dermatological changes were seen on sun-exposed skin. Brain MRI revealed global atrophy. Whole exome sequencing and familial segregation analysis revealed two compound heterozygous mutations in the <em>ERCC4</em> gene, confirming XP-F diagnosis.</div></div><div><h3>Literature review</h3><div>An extensive literature review identified sixteen studies reporting patients with confirmed XP as well as chorea as extrapyramidal movement disorder in their clinical phenotype. The clinical phenotyping of these patients was carefully evaluated, listed and analysed. In addition, available genetic data was systematically collected and reviewed.</div></div><div><h3>Conclusion</h3><div>We describe an XP-patient with a Huntingtońs disease (HD)-like syndrome with discrete cerebellar ataxia. Through reviewing the literature, we identified a total of 41 XP-patients with chorea. Therefore, we suggest testing of NER genes in patients with a HD-like syndrome and negative genetic testing for HD, especially when dermatological changes and atactic features are present.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100340"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143927813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opicapone improves end-of-dose neuropsychiatric fluctuations in patients with Parkinson’s disease","authors":"Roberta De Fiores ,&nbsp;Iolanda Martino ,&nbsp;Andrea Quattrone ,&nbsp;Basilio Vescio ,&nbsp;Gennarina Arabia ,&nbsp;Antonio Gambardella ,&nbsp;Maurizio Morelli","doi":"10.1016/j.prdoa.2025.100343","DOIUrl":"10.1016/j.prdoa.2025.100343","url":null,"abstract":"<div><h3>Introduction</h3><div>Non-motor fluctuations (NMF) represent one of the main complications that patients with Parkinson’s disease (PD) may experience during long-term levodopa treatment. Opicapone (OPC), a COMT-inhibitor indicated for end-of-dose motor fluctuations (MF), has not been extensively investigated for the management of NMF. We evaluate the efficacy of OPC on end-of-dose neuropsychiatric fluctuations, the most frequent and severe NMF.</div></div><div><h3>Methods</h3><div>We assessed 15 PD patients who underwent treatment with OPC (PD-OPC) compared to a control group of 15 PD patients (PD-CTRL). All patients had end-of-dose MF and NMF, confirmed by 19-item Wearing-Off Questionnaire (WOQ-19). For each, we identified the first end-of-dose deterioration period through MDS-UPDRS-III administered every 30 min over two consecutive days. On the third day, a comprehensive clinical and neuropsychological battery was administered during this designated period. Subsequently, OPC was prescribed to PD-OPC. After 6 months, patients were re-evaluated using the same baseline assessments during the same end-of-dose period.</div></div><div><h3>Results</h3><div>At 6-month follow-up, PD-OPC showed significant improvement in the following tests: WOQ-19 (<em>p</em> &lt; 0.001), total MDS-UPDRS and each of its four parts (<em>p</em> &lt; 0.001), NMSS (<em>p</em> &lt; 0.001), executive functions/attention (Weigl’s, <em>p</em> &lt; 0.001; FAS, <em>p</em> &lt; 0.001; FAB, <em>p</em> &lt; 0.001; STROOP, <em>p</em> = 0.001) and mood related-symptoms (BDI-II, HAM-A; both <em>p</em> = 0.001). There was a slightly significant difference in Visual Search (<em>p</em> = 0.018), and no differences in RAVLT-I <em>(p</em> = 0.323), and RAVLT-D (<em>p</em> = 0.155) scores. At follow-up, PD-CTRL showed no significant differences in WOQ-19, motor scales, and neuropsychological tests compared to baseline.</div></div><div><h3>Conclusion</h3><div>OPC improved end-of-dose fluctuations in anxiety/depression, and executive functions/attention, while memory and visuospatial abilities showed little or no significant changes.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100343"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of the continuous subcutaneous infusion of foslevodopa-foscarbidopa on swallowing in patients with Parkinson’s disease","authors":"Makito Hirano ,&nbsp;Makoto Samukawa ,&nbsp;Chiharu Isono ,&nbsp;Rino Inada ,&nbsp;Yuta Fukumoto ,&nbsp;Keisuke Yoshikawa ,&nbsp;Hitoshi Namura ,&nbsp;Hanami Sakata ,&nbsp;Takahiro Hisatomi ,&nbsp;Toru Michiura ,&nbsp;Hiroto Nakamura ,&nbsp;Akira Morita ,&nbsp;Genki Hoshino ,&nbsp;Kensuke Yamana ,&nbsp;Atsushi Terayama ,&nbsp;Yuji Higashimoto ,&nbsp;Yoshiyuki Mitsui ,&nbsp;Yoshitaka Nagai","doi":"10.1016/j.prdoa.2025.100378","DOIUrl":"10.1016/j.prdoa.2025.100378","url":null,"abstract":"<div><h3>Background</h3><div>Dysphagia is a potentially fatal symptom of Parkinson’s disease (PD) and is characterized by frequent silent aspiration, a known risk factor for aspiration pneumonia. A previous study has reported that the dopamine agonist rotigotine (levodopa equivalent dose of 60 mg/day) delivered via transdermal patch improves swallowing function more effectively than oral levodopa (200 mg/day), highlighting the importance of continuous dopaminergic stimulation (CDS) in managing dysphagia. To achieve CDS, patients with advanced PD may require device-assisted therapies (DATs), including levodopa–carbidopa intestinal gel (LCIG), which have significantly improved swallowing function on some measures. In contrast, swallowing function is an important prognostic factor for patients with PD undergoing LCIG. Continuous subcutaneous infusion of foslevodopa/foscarbidopa (CSCI-FF) is a newly developed DAT; however, its effect on swallowing function remains unknown.</div></div><div><h3>Methods</h3><div>This retrospective open-label evaluator-blinded study included seven patients with PD. Swallowing function was assessed using videofluoroscopic swallow studies (VFSS) conducted before and after initiating CSCI-FF. Evaluations included the Japanese Swallowing Scale, the Dysphagia Outcome and Severity Scale (DOSS), Penetration/Aspiration Scale, oral transit time (OTT), and pharyngeal transit time (PTT).</div></div><div><h3>Results</h3><div>Following the introduction of CSCI-FF, results of VFSS showed significant improvement in the total score of the Japanese swallowing scale, OTT, and PTT.</div></div><div><h3>Conclusions</h3><div>This study provides preliminary evidence that CSCI-FF may partially improve swallowing function in patients with advanced PD. Further research with larger cohorts is warranted.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"13 ","pages":"Article 100378"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to treat orthostatic tremor – Cohort study and systematic review","authors":"W.A. Babeliowsky ,&nbsp;M.A. Meulepas ,&nbsp;A.W.G. Buijink ,&nbsp;R.M.A. de Bie ,&nbsp;A.F. van Rootselaar","doi":"10.1016/j.prdoa.2025.100318","DOIUrl":"10.1016/j.prdoa.2025.100318","url":null,"abstract":"<div><h3>Introduction</h3><div>Orthostatic tremor (OT) is a highly disabling condition. Effectiveness of treatments is largely unverified and no treatment guideline exists. The objective of this study is to evaluate the efficacy and adverse effects of treatments used for OT.</div></div><div><h3>Methods</h3><div>Patients from our online OT-registry were compared to findings from a systematic search in PUBMED. The search included original articles describing clinical features in human primary OT (electromyography peak frequency ≥ 13 Hz), in English or Dutch, and published after 1985. Outcome measures were prescribed treatments and their efficacy (percentage of patients per treatment with a reduction of tremor symptoms) and adverse effects.</div></div><div><h3>Results</h3><div>A total of 78 primary OT patients in the Netherlands and 613 OT patients from 74 articles, mostly case reports and cohort studies, were included. In the cohort from the Netherlands, perampanel showed both the highest efficacy and adverse effects. In the literature, clonazepam showed the highest efficacy, while data on adverse effects was lacking. Overall, pharmacological treatments were reported often to be insufficient. Bilateral deep brain stimulation (DBS) was reported to be effective in the majority of patients, without a higher prevalence of adverse effects.</div></div><div><h3>Conclusion</h3><div>Pharmacological treatment is sufficient in some patients, although overall efficacy is limited and often accompanied by adverse effects. Perampanel and clonazepam are first choice treatments. Surgical interventions seem suitable alternatives for medication resistant patients, although this is based on small studies. Future studies should use diagnostic criteria, standardized outcome scales and good study designs, to increase reliability of findings and comparability.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100318"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moving to a non-dopaminergic approach for the treatment of OFF fluctuations in Parkinson’s disease","authors":"Stuart H. Isaacson ,&nbsp;Peter Jenner","doi":"10.1016/j.prdoa.2025.100303","DOIUrl":"10.1016/j.prdoa.2025.100303","url":null,"abstract":"<div><div>In levodopa treated patients with Parkinson’s disease (PD), the standard approach to managing motor fluctuations is to adjust dopaminergic therapy. However, despite the availability of a wide armamentarium of dopaminergic medications, most patients treated with levodopa will still experience significant OFF time, and it is increasingly clear that motor fluctuations have a significant non-dopaminergic component. In this narrative review, we compare and contrast the therapeutic profiles of the only two non-dopaminergic medications approved in the US for the management of OFF time, namely amantadine and istradefylline. When compared against each other the two agents exemplify two different pharmacological approaches to treatment. Whereas amantadine has a multimodal pharmacology, istradefylline has highly specific actions at A_2A receptors which are highly expressed in the indirect pathway of the basal ganglia. We discuss how both offer an important alternative approach to treatment, without increasing total dopaminergic load. Clinicians can also consider that amantadine and istradefylline each have overlapping indications with classic dopaminergic medications, but with distinct mechanisms of action that can complement each other to reduce motor complications in patients already being treated with other dopaminergic agents.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100303"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143176205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Significant relief of parkinsonism and dystonia with levodopa in beta-propeller protein-associated neurodegeneration: a video case report and insights into the WDR45 c.400C>T mutation","authors":"Wen-Che Li ,&nbsp;Pou-Leng Cheong ,&nbsp;Kai-Hsiang Stanley Chen","doi":"10.1016/j.prdoa.2025.100345","DOIUrl":"10.1016/j.prdoa.2025.100345","url":null,"abstract":"<div><div>We describe a young woman with BPAN carrying c.400 C&gt;T mutation in WDR45. Her motor symptoms improved with low-dose levodopa. Notably, the absence of seizures in adulthood and Rett-like features in our patient, consistent with previous reports, may be distinct features of this variant compared to broader WDR45-related neurodevelopmental disorders population.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100345"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143935148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sedation and sleep safety of pimavanserin for Parkinsons’s disease psychosis: Review and exploratory analysis of clinical study data","authors":"Ana Berrio ,&nbsp;Lambros Chrones ,&nbsp;Victor Abler ,&nbsp;Robert A. Hauser","doi":"10.1016/j.prdoa.2025.100342","DOIUrl":"10.1016/j.prdoa.2025.100342","url":null,"abstract":"<div><div>Patients with Parkinson’s disease almost uniformly experience sleep disorders. Sleep disorders have been linked to the severity of cognitive impairment, which is also a comorbidity with Parkinson’s disease psychosis (PDP). Pimavanserin, a highly selective inverse agonist of the serotonin 2A receptor, is approved in the United States for the treatment of hallucinations and delusions in patients with PDP. Other atypical antipsychotics, such as quetiapine and clozapine, are frequently used off-label to treat PDP and have an increased risk of sedation and other sleep-related adverse events (eg, drowsiness, sedation). By contrast, a high degree of specificity for the serotonin 2A receptor may prevent pimavanserin from causing some of the off-target adverse events associated with other atypical antipsychotics. In this review and exploratory analysis, we summarize pimavanserin sleep- and sedation-related safety and tolerability data from past clinical trials, including 6 randomized controlled trials and 2 open-label extensions representing various pimavanserin doses (1 to 51 mg) in healthy volunteers, patients with PDP, and older patients with neurodegenerative disease. The results from our exploratory analyses suggest that pimavanserin may be associated with negligible levels of sedation and other sleep‑related adverse events and may provide improvements in nighttime sleep compared with placebo. Future head-to-head clinical trials will be needed for direct comparisons between pimavanserin and other atypical antipsychotics, such as quetiapine or clozapine.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100342"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143935147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effects of deep brain stimulation in subthalamic nucleus and globus pallidus interna on verbal fluency and working memory in adult populations with parkinson’s disease: A systematic review","authors":"Hannah Trotman ,&nbsp;Benjamin Jelley,&nbsp;Katja Umla-Runge","doi":"10.1016/j.prdoa.2025.100355","DOIUrl":"10.1016/j.prdoa.2025.100355","url":null,"abstract":"<div><h3>Background</h3><div>Deep Brain Stimulation (DBS) in the subthalamic nucleus and globus pallidus interna is a well-established treatment for motor symptoms in Parkinson’s Disease (PD). However, the cognitive effects of DBS, particularly on verbal fluency and working memory, remain less clear.</div></div><div><h3>Purpose</h3><div>This systematic review explores the comparative effects of subthalamic nucleus and globus pallidus interna DBS on verbal fluency and working memory in adults with PD, addressing gaps in current cognitive outcome data.</div></div><div><h3>Methods</h3><div>A comprehensive search of EMBASE, MEDLINE, EMCARE, and PsycINFO was conducted. Studies were selected based on predefined criteria, focusing on randomised and non-randomised controlled trials involving adult PD patients treated with subthalamic nucleus or globus pallidus interna DBS. Data extraction and risk of bias assessments were performed.</div></div><div><h3>Results</h3><div>Eight studies were included, with varied findings. Most studies observed a decline in verbal fluency following DBS, with no significant differences between subthalamic nucleus and globus pallidus interna targets. Working memory outcomes were also mixed; however, one study showed a statistically significant result favouring globus pallidus interna DBS for working memory.</div></div><div><h3>Conclusions</h3><div>The cognitive effects of DBS appear variable and target-independent, highlighting the need for individualised treatment planning. While DBS effectively addresses motor symptoms, its cognitive impacts, especially on verbal fluency and working memory, require further exploration. These findings support a more personalised DBS approach, considering cognitive profiles, implantation laterality, and long-term outcomes.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"13 ","pages":"Article 100355"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144261326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}