TY - JOUR
T1 - Cognitive and psychiatric outcomes in the GALAXY trial
T2 - Effect of anaesthesia in deep brain stimulation
AU - Holewijn, Rozemarije A.
AU - Zoon, Thomas J. C.
AU - Verbaan, Dagmar
AU - Bergfeld, Isidoor O.
AU - Verwijk, Esmée
AU - Geurtsen, Gert J.
AU - van Rooijen, Geeske
AU - van den Munckhof, Pepijn
AU - Bot, Maarten
AU - Denys, Damiaan A. J. P.
AU - de Bie, Rob M. A.
AU - Schuurman, P. Rick
N1 - Funding Information: RH and PvdM reported grants from Dutch Brain Foundation during the conduct of the study. DD received grants from ZonMw and Boston Scientific for a trial on deep brain stimulation for depression. RMADB reported grants from Hersenstichting Charitable Organization during the conduct of the study and grants from the Netherlands Organisation for Health Research and Development, Stichting Parkinson Nederland, GE Healthcare, Medtronic, Lysosomal Therapeutics and Neuroderm, all paid to institution, outside the submitted work. RS reported personal fees from Medtronic and Boston Scientific during the conduct of the study. Publisher Copyright: © Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2023/9/7
Y1 - 2023/9/7
N2 - Background: This study aims: (1) To compare cognitive and psychiatric outcomes after bilateral awake versus asleep subthalamic nucleus (STN) deep brain stimulation (DBS) surgery for Parkinson's disease (PD). (2) To explore the occurrence of psychiatric diagnoses, cognitive impairment and quality of life after surgery in our whole sample. (3) To validate whether we can predict postoperative cognitive decline. Methods: 110 patients with PD were randomised to receive awake (n=56) or asleep (n=54) STN DBS surgery. At baseline and 6-month follow-up, all patients underwent standardised assessments testing several cognitive domains, psychiatric symptoms and quality of life. Results: There were no differences on neuropsychological composite scores and psychiatric symptoms between the groups, but we found small differences on individual tests and cognitive domains. The asleep group performed better on the Rey Auditory Verbal Learning Test delayed memory test (f=4.2, p=0.04), while the awake group improved on the Rivermead Behavioural Memory Test delayed memory test. (f=4.4, p=0.04). The Stroop III score was worse for the awake group (f=5.5, p=0.02). Worse scores were present for Stroop I (Stroop word card) (f=6.3, p=0.01), Stroop II (Stroop color card) (f=46.4, p<0.001), Stroop III (Stroop color-word card) (f=10.8, p=0.001) and Trailmaking B/A (f=4.5, p=0.04). Improvements were seen on quality of life: Parkinson's Disease Questionnaire-39 (f=24.8, p<0.001), and psychiatric scales: Hamilton Depression Rating Scale (f=6.2, p=0.01), and Hamilton Anxiety Rating Scale (f=5.5, p=0.02). Conclusions: This study suggests that the choice between awake and asleep STN DBS does not affect cognitive, mood and behavioural adverse effects, despite a minor difference in memory. STN DBS has a beneficial effect on quality of life, mood and anxiety symptoms. Trial registration number: NTR5809.
AB - Background: This study aims: (1) To compare cognitive and psychiatric outcomes after bilateral awake versus asleep subthalamic nucleus (STN) deep brain stimulation (DBS) surgery for Parkinson's disease (PD). (2) To explore the occurrence of psychiatric diagnoses, cognitive impairment and quality of life after surgery in our whole sample. (3) To validate whether we can predict postoperative cognitive decline. Methods: 110 patients with PD were randomised to receive awake (n=56) or asleep (n=54) STN DBS surgery. At baseline and 6-month follow-up, all patients underwent standardised assessments testing several cognitive domains, psychiatric symptoms and quality of life. Results: There were no differences on neuropsychological composite scores and psychiatric symptoms between the groups, but we found small differences on individual tests and cognitive domains. The asleep group performed better on the Rey Auditory Verbal Learning Test delayed memory test (f=4.2, p=0.04), while the awake group improved on the Rivermead Behavioural Memory Test delayed memory test. (f=4.4, p=0.04). The Stroop III score was worse for the awake group (f=5.5, p=0.02). Worse scores were present for Stroop I (Stroop word card) (f=6.3, p=0.01), Stroop II (Stroop color card) (f=46.4, p<0.001), Stroop III (Stroop color-word card) (f=10.8, p=0.001) and Trailmaking B/A (f=4.5, p=0.04). Improvements were seen on quality of life: Parkinson's Disease Questionnaire-39 (f=24.8, p<0.001), and psychiatric scales: Hamilton Depression Rating Scale (f=6.2, p=0.01), and Hamilton Anxiety Rating Scale (f=5.5, p=0.02). Conclusions: This study suggests that the choice between awake and asleep STN DBS does not affect cognitive, mood and behavioural adverse effects, despite a minor difference in memory. STN DBS has a beneficial effect on quality of life, mood and anxiety symptoms. Trial registration number: NTR5809.
KW - COGNITION
KW - ELECTRICAL STIMULATION
KW - NEUROPSYCHIATRY
KW - PARKINSON'S DISEASE
UR - http://www.scopus.com/inward/record.url?scp=85172321152&partnerID=8YFLogxK
U2 - https://doi.org/10.1136/jnnp-2023-331791
DO - https://doi.org/10.1136/jnnp-2023-331791
M3 - Article
C2 - 37679030
SN - 0022-3050
JO - Journal of Neurology, Neurosurgery and Psychiatry
JF - Journal of Neurology, Neurosurgery and Psychiatry
M1 - jnnp-2023-331791
ER -