Influence of Body Mass Index (BMI) and Blood Pressure (BP) on Deep Brain Stimulation (DBS) Outcomes in Parkinson’s disease (PD) Patients (P4-11.003)

Abstract

<h3>Objective:</h3> PD literature supports a complex relationship between preoperative obesity, BP abnormalities, and post-DBS cognitive and motor outcomes. This study aims to improve on evidence associating BMI and BP with cognitive, emotional, and quality-of-life outcomes post-DBS. <h3>Background:</h3> Previous studies indicate obesity and hypertension increase intra-/ post-operative complications. Up to 65% of PD patients may be overweight or obese, with obese patients having less axial motor improvement and worsened cognitive function six months post-DBS. PD patients have also demonstrated increased BP fluctuations compared to healthy controls. <h3>Design/Methods:</h3> PD patients [n=28, Mage=62.6(8.8), 75% male, Medu=16.1(3.0), 92.9% STN) underwent pre-/post-DBS assessment (global cognition, language, memory, attention, processing speed, visuospatial ability) and emotional screenings via TeleNP. Systolic (M=130.0; SD=19.5) and diastolic (M=74.4; SD=16.0) BP (SBP, DBP), weight, and height were measured pre-DBS surgery. BMI was computed (M=27.3; SD=6.1). Logistic regression was used to predict neurocognitive performance using BMI, SBP, and DBP. <h3>Results:</h3> BMI, SBP, and DBP predicted decline in verbal reasoning in post-, compared to pre-, DBS testing, but not other assessed domains. Model coefficient estimates of 0.40 [<i>p</i>=.02, OR=1.5 (95% CI [1.07, 2.10])] for BMI, 0.13 [<i>p</i>=.04, OR=1.13 (95% CI [1.01, 1.28])] for SBP, and −0.15 [<i>p</i>=.08, OR=0.86 (95% CI [0.73, 1.02])] for DBP were indicated. Model fit was robust [X²(3)=14.2, <i>p</i>=.003]. While holding BP constant: each unit increase in BMI predicted a 50% increase in odds of verbal reasoning decline (one-half <i>SD</i> or more), and a unit increase in SBP (or decrease in DBP) predicted a 13% increase in odds (or, respectively, a 14% decrease in odds) of verbal reasoning decline. Post-DBS patient classification using BMI and BP predictors yield a .882 specificity and a .857 sensitivity. <h3>Conclusions:</h3> BMI, SBP, and DBP should be considered in predicting DBS surgical outcomes, particularly on verbal reasoning tasks. This small sample requires replication but is consistent with existing literature. <b>Disclosure:</b> Miss See has nothing to disclose. Dr. Harcourt has nothing to disclose. Annelly Buré-Reyes has nothing to disclose. Dr. Rodriguez has nothing to disclose. Dr. Luca has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Boston Scientific. Dr. Luca has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Signant Health. Jonathan Jagid has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medtronic Inc. The institution of Jonathan Jagid has received research support from Boston Scientific. The institution of Jonathan Jagid has received research support from Medtronic Inc. Bonnie Levin has nothing to disclose. Ms. Bullock has nothing to disclose. The institution of Dr. Haq has received research support from NINDS. The institution of Dr. Haq has received research support from the Parkinson’s Foundation. The institution of Dr. Haq has received research support from NIMH. Dr. Haq has a non-compensated relationship as a consultant with Medtronics that is relevant to AAN interests or activities. Dr. Haq has a non-compensated relationship as a consultant with Boston Scientific that is relevant to AAN interests or activities. Dr. Haq has a non-compensated relationship as a consultant with Abbott that is relevant to AAN interests or activities. Dr. Sarno has nothing to disclose.