INS NYC 2024 Program

Poster	Poster Session 02 Program Schedule 02/15/2024 08:00 am - 09:15 am Room: Shubert Complex (Posters 1-60) Poster Session 02: Aging \| MCI \| Neurodegenerative Disease - PART 1 Final Abstract #27 Reliable indices of change in verbal language competence in Parkinson's disease patients at 12-month intervals after subthalamic deep brain stimulation surgery Edoardo Aiello, Istituto Auxologico Italiano, Milan, Italy Francesca Mameli, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy Fabiana Ruggiero, Fondazione IRCCS Ca' Granda Ospedale maggiore Policlinico, Milan, Italy Eleonora Zirone, Fondazione IRCCS Ca' Granda Ospedale maggiuore Policlinico, Milan, Italy Barbara Poletti, Università degli Studi di Milano, Milan, Italy Linda Borellini, Fondazione IRCCS Ca' granda Ospedale Maggiore Policlinico, Milan, Italy Gaia Del Prete - Ferrucci, University of Bath, Bath, United Kingdom Gabriella Pravettoni, Università degli Studi di Milano, Milan, Italy Angelica De Sandi, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy Sergio Barbieri, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy Alberto Priori, Università degli Studi di Milano, Milan, Italy Roberta Ferrucci, Università degli Studi di Milano, Milan, Italy Category: Movement and Movement Disorders Keyword 1: Parkinson's disease Keyword 2: fluency Keyword 3: deep brain stimulation Objective: In patients with Parkinson's disease (PD), deep brain stimulation (DBS) surgery on the subthalamic nucleus (STN) may result in cognitive side effects, which are known to be effectively detected by verbal fluency (VF) testing. The aim of this study is to derive standardized regression-based (SRB) reliable change indices (RCIs) to capture clinically meaningful variations in VF performances in an Italian cohort of PD patients undergoing STN-DBS one year after surgery. Participants and Methods: We administered the Alternate Verbal Fluency Battery (AVFB) – which includes phonemic (PVF), semantic (SVF), and alternative VF tests (AVF), as well as a Composite Shifting Index (CSI) reflecting the cost of switching from a single-cued to a double-cued VF task – to 36 PD patients [21 males; (M±SD) age: 58±8; education: 13±4; disease duration in years: 12±4; Montreal Cognitive Assessment: 26±2] undergoing STN-DBS both before (T0) and 12 months after (T1) surgery. At T0, we evaluated patients’ motor status using the Unified Parkinson's Disease Rating Scale-III (UPDRS-III) and we recorded the L-dopa equivalent daily dose (LEDD). Ceiling and practice effects, as well as test-retest reliability, were examined. RCIs were derived on AVFB scores – adjusted for demographic confounders according to current Italian norms – using a stepwise, regression-based procedure that took into account T0 disease duration, UPDRS-III and LEDD in addition to T0 cognitive performances. Results: Ceiling effects in the AVFB scores were absent at both T0 and T1 (skewness values ≤\|.30\| and \|.69\|, respectively). At the group level, patients' PVF (p < 0.001) and SVF (p < 0.001) scores worsened, but not AVF and CSI scores. PVF, SVF and AVF scores (ICC=0.76) were reliable at retest (ICC=0.71-87), but this was not true for CSI (ICC=0.58). In the SRB model, AVFB scores at T0 were always predictive of those at T1 (p. 006). Among non-cognitive predictors, only UPDRS-III-on was significant for the regression of AVF and CSI scores at T0. Based on these results, we constructed SRB equations to derive RCIs for each adjusted score in the AVFB. Applying the current RCIs, we found idiosyncratic patterns of longitudinal trends that differed from those at the group level, with the vast majority of patients remaining stable over time. Conclusions: The present study provides Italian practitioners and researchers with SRB-RCIs to detect meaningful differences in VF performance of PD patients undergoing STN-DBS one year after surgery. Furthermore, this report reinforces the notion that ad hoc statistical methods such as the derivation of SRB-RCIs are crucial to accurately determine whether or not patients actually experience postoperative VF variations.

Poster

02/15/2024
08:00 am - 09:15 am
Room: Shubert Complex (Posters 1-60)

Poster Session 02: Aging | MCI | Neurodegenerative Disease - PART 1

Final Abstract #27

Reliable indices of change in verbal language competence in Parkinson's disease patients at 12-month intervals after subthalamic deep brain stimulation surgery

Edoardo Aiello, Istituto Auxologico Italiano, Milan, Italy
Francesca Mameli, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
Fabiana Ruggiero, Fondazione IRCCS Ca' Granda Ospedale maggiore Policlinico, Milan, Italy
Eleonora Zirone, Fondazione IRCCS Ca' Granda Ospedale maggiuore Policlinico, Milan, Italy
Barbara Poletti, Università degli Studi di Milano, Milan, Italy
Linda Borellini, Fondazione IRCCS Ca' granda Ospedale Maggiore Policlinico, Milan, Italy
Gaia Del Prete - Ferrucci, University of Bath, Bath, United Kingdom
Gabriella Pravettoni, Università degli Studi di Milano, Milan, Italy
Angelica De Sandi, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
Sergio Barbieri, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
Alberto Priori, Università degli Studi di Milano, Milan, Italy
Roberta Ferrucci, Università degli Studi di Milano, Milan, Italy

Category: Movement and Movement Disorders

Keyword 1: Parkinson's disease
Keyword 2: fluency
Keyword 3: deep brain stimulation

Objective:

In patients with Parkinson's disease (PD), deep brain stimulation (DBS) surgery on the subthalamic nucleus (STN) may result in cognitive side effects, which are known to be effectively detected by verbal fluency (VF) testing. The aim of this study is to derive standardized regression-based (SRB) reliable change indices (RCIs) to capture clinically meaningful variations in VF performances in an Italian cohort of PD patients undergoing STN-DBS one year after surgery.

Participants and Methods:

We administered the Alternate Verbal Fluency Battery (AVFB) – which includes phonemic (PVF), semantic (SVF), and alternative VF tests (AVF), as well as a Composite Shifting Index (CSI) reflecting the cost of switching from a single-cued to a double-cued VF task – to 36 PD patients [21 males; (M±SD) age: 58±8; education: 13±4; disease duration in years: 12±4; Montreal Cognitive Assessment: 26±2] undergoing STN-DBS both before (T0) and 12 months after (T1) surgery. At T0, we evaluated patients’ motor status using the Unified Parkinson's Disease Rating Scale-III (UPDRS-III) and we recorded the L-dopa equivalent daily dose (LEDD). Ceiling and practice effects, as well as test-retest reliability, were examined. RCIs were derived on AVFB scores – adjusted for demographic confounders according to current Italian norms – using a stepwise, regression-based procedure that took into account T0 disease duration, UPDRS-III and LEDD in addition to T0 cognitive performances.

Results:

Ceiling effects in the AVFB scores were absent at both T0 and T1 (skewness values ≤|.30| and |.69|, respectively). At the group level, patients' PVF (p < 0.001) and SVF (p < 0.001) scores worsened, but not AVF and CSI scores. PVF, SVF and AVF scores (ICC=0.76) were reliable at retest (ICC=0.71-87), but this was not true for CSI (ICC=0.58). In the SRB model, AVFB scores at T0 were always predictive of those at T1 (p. 006). Among non-cognitive predictors, only UPDRS-III-on was significant for the regression of AVF and CSI scores at T0. Based on these results, we constructed SRB equations to derive RCIs for each adjusted score in the AVFB. Applying the current RCIs, we found idiosyncratic patterns of longitudinal trends that differed from those at the group level, with the vast majority of patients remaining stable over time.

Conclusions:

The present study provides Italian practitioners and researchers with SRB-RCIs to detect meaningful differences in VF performance of PD patients undergoing STN-DBS one year after surgery. Furthermore, this report reinforces the notion that ad hoc statistical methods such as the derivation of SRB-RCIs are crucial to accurately determine whether or not patients actually experience postoperative VF variations.