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Title

Hippocampal atrophy predicts conversion to dementia after STN-DBS in Parkinson's disease
Authors
Aybek, Selma
Lazeyras, François
Gronchi-Perrin, Aline
Burkhard, Pierre
Villemure, Jean-Guy
Vingerhoets, François
Published in Parkinsonism & Related Disorders. 2009, vol. 15, no. 7, p. 521-524
Abstract 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.
Keywords Aged — Atrophy/complications/etiology/pathology — 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
Identifiers
PMID: 19349206
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Structures
Faculté de médecine / Section de médecine clinique / Département des neurosciences cliniques
Research groups Groupe Pierre Burkhard (neurologie) (154)
Groupe Lazeyras Francois (IRM fonctionnelle et métabolique) (539)
Citation
(ISO format) 		AYBEK, Selma et al. Hippocampal atrophy predicts conversion to dementia after STN-DBS in Parkinson's disease. In: Parkinsonism & Related Disorders, 2009, vol. 15, n° 7, p. 521-524. doi: 10.1016/j.parkreldis.2009.01.003 https://archive-ouverte.unige.ch/unige:19652

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Deposited on : 2012-04-23

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