Predicting cognition after subthalamic Deep Brain Stimulation in Parkinson’s Disease

Cognitive deficits have a high impact on quality of life in Parkinson’s disease (PD). This study takes into account the multifaceted etiology of cognition to estimate the cognitive outcome after deep brain stimulation (DBS) surgery in PD. Clinical, neuropsychological, perioperative, neuroimaging- and laboratory-based risk factors for cognitive dysfunction were prospectively assessed prior to surgery in 57 patients (21 female; age 60.2 ± 8.2; disease duration 10.5 ± 5.9 years, preregistered 9 June 2019 at clinicaltrials.gov, NCT03982953). Elastic net regularized regression and leave-one-out cross-validation were used to fit a multivariable model with the Montréal Cognitive Assessment (MoCA) change one year after surgery as primary outcome. The backward span had the most robust association with the cognitive outcome (rho = 0.499, p < 0.001**; c = 0.302). We propose a post-hoc prediction model for cognition based on the baseline MoCA and backward span (R² = 0.50). After clinical validation, our short and easily applicable prediction model could improve informed therapeutic decision making.