Can cognitive decline be the nemesis of motor improvement secondary to deep brain stimulation?

Pre-operative factors As the study rightly points out, an older age, a longer disease duration, the past history of depression or psychosis, the freezing of gait in the OFF phase, worse ADL scores in the ON phase, a lower levodopa response of the UPDRS III axial subscores, and a poor performance in the Addenbrooke's Cognitive Examination and WCST are associated with early onset of dementia. [4] In a study at our institution, our team identified key factors like an age of ≥70 years, on anticoagulation therapy, behavioral problems unrelated to motor disease, cognitive impairment, requiring/receiving treatment for cardiopulmonary disease or other major systematic disease, frequent falls, poor social support, and need for bilateral treatment of motor disease symptoms, which were associated with a difficult postoperative course. Bilateral subthalamic nucleus (STN) targets in patients with mild cognitive impairment will increase the risk of cognitive decline.