INS NYC 2024 Program

Poster	Poster Session 04 Program Schedule 02/15/2024 12:00 pm - 01:15 pm Room: Shubert Complex (Posters 1-60) Poster Session 04: Neuroimaging \| Neurostimulation/Neuromodulation \| Teleneuropsychology/Technology Final Abstract #15 Long-Term Change of Instrumental Activities of Daily Living Change in Parkinson's Disease After Subthalamic Deep Brain Stimulation Ondrej Bezdicek, First Faculty of Medicine and General University Hospital in Prague, Charles University, Department of Neurology and Centre of Clinical Neuroscience, Prague, Czech Republic, Prague, Czechia Josef Mana, First Faculty of Medicine and General University Hospital in Prague, Charles University, Department of Neurology and Centre of Clinical Neuroscience, Prague, Czech Republic, Prague, Czechia Martina Kvapilová, First Faculty of Medicine and General University Hospital in Prague, Charles University, Department of Neurology and Centre of Clinical Neuroscience, Prague, Czech Republic, Prague, Czechia Filip Růžička, First Faculty of Medicine and General University Hospital in Prague, Charles University, Department of Neurology and Centre of Clinical Neuroscience, Prague, Czech Republic, Prague, Czechia Anna Fečíková, First Faculty of Medicine and General University Hospital in Prague, Charles University, Department of Neurology and Centre of Clinical Neuroscience, Prague, Czech Republic, Prague, Czechia Evžen Růžička, First Faculty of Medicine and General University Hospital in Prague, Charles University, Department of Neurology and Centre of Clinical Neuroscience, Prague, Czech Republic, Prague, Czechia Jan Roth, First Faculty of Medicine and General University Hospital in Prague, Charles University, Department of Neurology and Centre of Clinical Neuroscience, Prague, Czech Republic, Prague, Czechia Pavel Filip, First Faculty of Medicine and General University Hospital in Prague, Charles University, Department of Neurology and Centre of Clinical Neuroscience, Prague, Czech Republic, Prague, Czechia Petra Štofániková, First Faculty of Medicine and General University Hospital in Prague, Charles University, Department of Neurology and Centre of Clinical Neuroscience, Prague, Czech Republic, Prague, Czechia Jan Peregrin, First Faculty of Medicine and General University Hospital in Prague, Charles University, Department of Neurology and Centre of Clinical Neuroscience, Prague, Czech Republic, Prague, Czechia Markéta Volfová, First Faculty of Medicine and General University Hospital in Prague, Charles University, Department of Neurology and Centre of Clinical Neuroscience, Prague, Czech Republic, Prague, Czechia Kateřina Zárubová, Second Faculty of Medicine and Motol University Hospital, Charles University, Department of Neurology, Prague, Czech Republic, Prague, Czechia Robert Jech, First Faculty of Medicine and General University Hospital in Prague, Charles University, Department of Neurology and Centre of Clinical Neuroscience, Prague, Czech Republic, Prague, Czechia Category: Movement and Movement Disorders Keyword 1: deep brain stimulation Keyword 2: activities of daily living Keyword 3: Parkinson's disease Objective: Deep brain stimulation of the subthalamic nucleus (STN DBS) is an effective treatment for tremor, slowness, rigidity, dystonia and dyskinesia, i.e., some motor symptoms caused by Parkinson’s disease (PD). However, both STN DBS and PD can lead to cognitive decline resulting in a decrease in patients’ quality of life primarily via its negative effect on instrumental activities of daily living (IADL). Since cognitive impairment in STN DBS-treated PD patients tends to develop gradually over years after surgery, evaluating long-term change in IADL is crucial for understanding the effect of STN DBS and PD-related cognitive impairment on patients’ everyday functioning. To assess long-term post-surgery change (i.e., decline or improvement) in self-reported IADL in people with PD treated with STN DBS. Participants and Methods: A total of 70 patients with a clinical diagnosis of PD (mean age 56.14±8.48 years at surgery, 58% males) treated with STN DBS in combination with dopaminergic therapy were enrolled in the study. Only patients with pre-surgery and at least one post-surgery assessment of IADL were included. Patients’ self-reported difficulties with IADL were recorded before (n = 70) as well as one (n = 48), three (n = 40), and five (n = 13) years after surgery using Pfeffer’s Functional Activities Questionnaire (FAQ). Data was analyzed using a Bayesian generalised linear mixed model (GLMM) with FAQ as a dependent variable modelled via hurdle lognormal likelihood to estimate the median change of IADL difficulties at various time points after surgery. To account for the unbalanced research design, patient-specific medians were modelled as random effects. Results: At pre-surgery assessment, patients reported IADL difficulties on an average level of three (out of thirty) FAQ points (95% CI [2.24, 3.88]). At one-, three- and five years post-surgery there was respectively 85%, 84% and 60% probability of IADL difficulties increase by 0.59 (95% CI [-0.56, 1.88]), 0.58 (95% CI [-0.65, 1.84]) and 0.21 (95% CI [-1.47, 2.21]) FAQ points compared to the pre-surgery level. Conclusions: Our results indicate a slight, however, gradual decline in IADL after STN DBS surgery in PD. Although the expected level of IADL difficulties assessed by FAQ can change slightly after surgery, the data are consistent with a relatively low median level of self-reported IADL difficulties in PD patients treated with STN-DBS. Thus, STN DBS appears to be a safe treatment with respect to IADL up to five years post-surgery.

Poster

02/15/2024
12:00 pm - 01:15 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 04: Neuroimaging | Neurostimulation/Neuromodulation | Teleneuropsychology/Technology

Final Abstract #15

Long-Term Change of Instrumental Activities of Daily Living Change in Parkinson's Disease After Subthalamic Deep Brain Stimulation

Ondrej Bezdicek, First Faculty of Medicine and General University Hospital in Prague, Charles University, Department of Neurology and Centre of Clinical Neuroscience, Prague, Czech Republic, Prague, Czechia
Josef Mana, First Faculty of Medicine and General University Hospital in Prague, Charles University, Department of Neurology and Centre of Clinical Neuroscience, Prague, Czech Republic, Prague, Czechia
Martina Kvapilová, First Faculty of Medicine and General University Hospital in Prague, Charles University, Department of Neurology and Centre of Clinical Neuroscience, Prague, Czech Republic, Prague, Czechia
Filip Růžička, First Faculty of Medicine and General University Hospital in Prague, Charles University, Department of Neurology and Centre of Clinical Neuroscience, Prague, Czech Republic, Prague, Czechia
Anna Fečíková, First Faculty of Medicine and General University Hospital in Prague, Charles University, Department of Neurology and Centre of Clinical Neuroscience, Prague, Czech Republic, Prague, Czechia
Evžen Růžička, First Faculty of Medicine and General University Hospital in Prague, Charles University, Department of Neurology and Centre of Clinical Neuroscience, Prague, Czech Republic, Prague, Czechia
Jan Roth, First Faculty of Medicine and General University Hospital in Prague, Charles University, Department of Neurology and Centre of Clinical Neuroscience, Prague, Czech Republic, Prague, Czechia
Pavel Filip, First Faculty of Medicine and General University Hospital in Prague, Charles University, Department of Neurology and Centre of Clinical Neuroscience, Prague, Czech Republic, Prague, Czechia
Petra Štofániková, First Faculty of Medicine and General University Hospital in Prague, Charles University, Department of Neurology and Centre of Clinical Neuroscience, Prague, Czech Republic, Prague, Czechia
Jan Peregrin, First Faculty of Medicine and General University Hospital in Prague, Charles University, Department of Neurology and Centre of Clinical Neuroscience, Prague, Czech Republic, Prague, Czechia
Markéta Volfová, First Faculty of Medicine and General University Hospital in Prague, Charles University, Department of Neurology and Centre of Clinical Neuroscience, Prague, Czech Republic, Prague, Czechia
Kateřina Zárubová, Second Faculty of Medicine and Motol University Hospital, Charles University, Department of Neurology, Prague, Czech Republic, Prague, Czechia
Robert Jech, First Faculty of Medicine and General University Hospital in Prague, Charles University, Department of Neurology and Centre of Clinical Neuroscience, Prague, Czech Republic, Prague, Czechia

Category: Movement and Movement Disorders

Keyword 1: deep brain stimulation
Keyword 2: activities of daily living
Keyword 3: Parkinson's disease

Objective:

Deep brain stimulation of the subthalamic nucleus (STN DBS) is an effective treatment for tremor, slowness, rigidity, dystonia and dyskinesia, i.e., some motor symptoms caused by Parkinson’s disease (PD). However, both STN DBS and PD can lead to cognitive decline resulting in a decrease in patients’ quality of life primarily via its negative effect on instrumental activities of daily living (IADL). Since cognitive impairment in STN DBS-treated PD patients tends to develop gradually over years after surgery, evaluating long-term change in IADL is crucial for understanding the effect of STN DBS and PD-related cognitive impairment on patients’ everyday functioning.

To assess long-term post-surgery change (i.e., decline or improvement) in self-reported IADL in people with PD treated with STN DBS.

Participants and Methods:

A total of 70 patients with a clinical diagnosis of PD (mean age 56.14±8.48 years at surgery, 58% males) treated with STN DBS in combination with dopaminergic therapy were enrolled in the study. Only patients with pre-surgery and at least one post-surgery assessment of IADL were included. Patients’ self-reported difficulties with IADL were recorded before (n = 70) as well as one (n = 48), three (n = 40), and five (n = 13) years after surgery using Pfeffer’s Functional Activities Questionnaire (FAQ). Data was analyzed using a Bayesian generalised linear mixed model (GLMM) with FAQ as a dependent variable modelled via hurdle lognormal likelihood to estimate the median change of IADL difficulties at various time points after surgery. To account for the unbalanced research design, patient-specific medians were modelled as random effects.

Results:

At pre-surgery assessment, patients reported IADL difficulties on an average level of three (out of thirty) FAQ points (95% CI [2.24, 3.88]). At one-, three- and five years post-surgery there was respectively 85%, 84% and 60% probability of IADL difficulties increase by 0.59 (95% CI [-0.56, 1.88]), 0.58 (95% CI [-0.65, 1.84]) and 0.21 (95% CI [-1.47, 2.21]) FAQ points compared to the pre-surgery level.

Conclusions:

Our results indicate a slight, however, gradual decline in IADL after STN DBS surgery in PD. Although the expected level of IADL difficulties assessed by FAQ can change slightly after surgery, the data are consistent with a relatively low median level of self-reported IADL difficulties in PD patients treated with STN-DBS. Thus, STN DBS appears to be a safe treatment with respect to IADL up to five years post-surgery.