Hippocampal atrophy predicts conversion to dementia after STN-DBS in Parkinson's disease.

Détails

ID Serval
serval:BIB_C665D36A54D2
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Hippocampal atrophy predicts conversion to dementia after STN-DBS in Parkinson's disease.
Périodique
Parkinsonism & Related Disorders
Auteur(s)
Aybek S., Lazeyras F., Gronchi-Perrin A., Burkhard P.R., Villemure J.G., Vingerhoets F.J.
ISSN
1873-5126[electronic]
Statut éditorial
Publié
Date de publication
2009
Volume
15
Numéro
7
Pages
521-524
Langue
anglais
Résumé
BACKGROUND: Hippocampal atrophy (HA) is a known predictor of dementia in Alzheimer's disease. HA has been found in advanced Parkinson's disease (PD), but no predicting value has been demonstrated yet. The identification of such a predictor in candidates for subthalamic deep brain stimulation (STN-DBS) would be of value. Our objective was to compare preoperative hippocampal volumes (HV) between PD patients who subsequently converted to dementia (PDD) after STN-DBS and those who did not (PDnD). METHODS: From a cohort of 70 consecutive STN-DBS treated PD patients, 14 converted to dementia over 25.6+/-20.2 months (PDD). They were compared to 14 matched controls (PDnD) who did not convert to dementia after 43.9+/-11.7 months. On the preoperative 3D MPRAGE MRI images, HV and total brain volumes (TBV) were measured by a blinded investigator using manual and automatic segmentation respectively. RESULTS: PDD had smaller preoperative HV than PDnD (1.95+/-0.29 ml; 2.28+/-0.33 ml; p<0.01). This difference reinforced after normalization for TBV (3.28+/-0.48, 3.93+/-0.60; p<0.01). Every 0.1 ml decrease of HV increased the likelihood to develop dementia by 24.6%. A large overlap was found between PD and PDnD HVs, precluding the identification of a cut-off score. CONCLUSIONS: As in Alzheimer's disease, HA may be a predictor of the conversion to dementia in PD. This preoperative predictor suggests that the development of dementia after STN-DBS is related to the disease progression, rather then the procedure. Further studies are needed to define a cut-off score for HA, in order to affine its predictive value for an individual patient.
Mots-clé
Aged, Atrophy/complications, Atrophy/etiology, Case-Control Studies, Cohort Studies, Deep Brain Stimulation/adverse effects, Dementia/etiology, Female, Hippocampus/pathology, Humans, Imaging, Three-Dimensional/methods, Logistic Models, Magnetic Resonance Imaging/methods, Male, Mental Status Schedule, Middle Aged, Parkinson Disease/therapy, Predictive Value of Tests, Severity of Illness Index
Pubmed
Web of science
Création de la notice
30/10/2009 16:30
Dernière modification de la notice
20/08/2019 15:41
Données d'usage