Nucleus basalis of Meynert predicts cognition after deep brain stimulation in Parkinson's disease

Dorothee Kübler; Sophie Katharina Wellmann; Jakob Kaminski; Cornelia Skowronek; Gerd-Helge Schneider; Wolf-Julian Neumann; Kerstin Ritter; Andrea Kühn

doi:10.1016/j.parkreldis.2021.12.002

Nucleus basalis of Meynert predicts cognition after deep brain stimulation in Parkinson's disease

Parkinsonism Relat Disord. 2022 Jan:94:89-95. doi: 10.1016/j.parkreldis.2021.12.002. Epub 2021 Dec 8.

Authors

Dorothee Kübler¹, Sophie Katharina Wellmann², Jakob Kaminski³, Cornelia Skowronek², Gerd-Helge Schneider⁴, Wolf-Julian Neumann², Kerstin Ritter⁵, Andrea Kühn⁶

Affiliations

¹ Movement Disorder and Neuromodulation Unit, Department of Neurology and Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany. Electronic address: dorothee.kuebler@charite.de.
² Movement Disorder and Neuromodulation Unit, Department of Neurology and Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany.
³ Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany.
⁴ Department of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany.
⁵ Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Berlin Center for Advanced Neuroimaging, Bernstein Center for Computational Neuroscience, Berlin, Germany.
⁶ Movement Disorder and Neuromodulation Unit, Department of Neurology and Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Berlin Center for Advanced Neuroimaging, Bernstein Center for Computational Neuroscience, Berlin, Germany; Exzellenzcluster NeuroCure, Charité - Universitätsmedizin Berlin, Berlin, Germany; Berlin School of Mind and Brain, Humboldt - Universität zu Berlin, Berlin, Germany; Deutsches Zentrum für Neurodegenerative Erkrankungen, Berlin, Germany.

PMID: 34896929
DOI: 10.1016/j.parkreldis.2021.12.002

Abstract

Introduction: Subthalamic DBS in Parkinson's disease has been associated with cognitive decline in few cases. Volume reduction of the nucleus basalis of Meynert (NBM) seems to precede cognitive impairment in Parkinson's disease. In this retrospective study, we evaluated NBM volume as a predictor of cognitive outcome 1 year after subthalamic DBS.

Methods: NBM volumes were calculated from preoperative MRIs using voxel-based morphometry. Cognitive outcome was defined as the relative change of MMSE or DemTect scores from pre-to 1 year postoperatively. A multiple linear regression analysis adjusted for the number of cognitive domains affected in the preoperative neuropsychological testing and UPDRS III was conducted. To account for other variables and potential non-linear effects, an additional machine learning analysis using random forests was applied.

Results: 55 patients with Parkinson's disease (39 male, age 61.4 ± 7.5 years, disease duration 10.8 ± 4.7 years) who received bilateral subthalamic DBS electrodes at our center were included. Although overall cognition did not change significantly, individual change in cognitive abilities was variable. Cognitive outcome could be predicted based on NBM size (B = 208.98, p = 0.022*) in the regression model (F(3,49) = 2.869; R² of 0.149; p = 0.046*). Using random forests with more variables, cognitive outcome could also be predicted (average root mean squared error between predicted and true cognitive change 11.28 ± 9.51, p = 0.039*). Also in this model, NBM volume was the most predictive variable.

Conclusion: NBM volume can be used as a simple non-invasive predictor for cognitive outcome after DBS in Parkinson's disease, especially when combined with other clinical parameters that are prognostically relevant.

Keywords: Basal forebrain; Cognition; Deep brain stimulation; Nucleus basalis of meynert; Parkinson's disease.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Basal Nucleus of Meynert
Cognition
Deep Brain Stimulation*
Female
Humans
Male
Middle Aged
Parkinson Disease* / complications
Parkinson Disease* / diagnostic imaging
Parkinson Disease* / therapy
Retrospective Studies

Grants and funding

WT_/Wellcome Trust/United Kingdom