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Abstract：
Background/Objectives: High cognitive reserve (CR) has been shown to have beneficial effects on global cognition, cognitive decline, and risk of dementia in Parkinson\'s disease (PD). We evaluated the influence of CR on the long-term cognitive outcomes of patients with PD who underwent subthalamic nucleus deep brain stimulation (STN-DBS). Methods: Twenty-five patients with PD underwent neuropsychological screening using the Montreal Cognitive Assessment (MoCA) at baseline, 1 year, and 5 years after bilateral STN-DBS. CR was assessed using the Cognitive Reserve Index questionnaire. According to CR score, patients were assigned to two different groups (LowCR group ≤ 130, HighCR group > 130). Results: Our data showed that patients in the HighCR group obtained a better performance with the MoCA total score at long-term follow-up compared to those in the LowCR group ([mean ± SE] LowCR group: 21.4 ± 1.2 vs. HighCR group: 24.5 ± 1.3, p = 0.05). The cognitive profile of the HighCR group remained unchanged over time. Conversely, the LowCR group had worse global cognition 5 years after surgery (T0: 25.3 ± 0.6 vs. T2: 21.4 ± 1.2, p = 0.02). Cognitive decline was not associated with mood, demographics, or clinical variables. Conclusions: These preliminary findings suggest that higher CR may be protective in PD cognition after STN-DBS. Specifically, a high CR may help cope with long-term decline in the context of surgical treatment. Quantifying a patient\'s CR could lead to more personalized medical care, tailoring postoperative support and monitoring for those at higher risk of cognitive decline.
摘要：
背景/目标：高认知储备（CR）已被证明对全球认知有有益的影响，认知能力下降,和帕金森病（PD）痴呆的风险。我们评估了CR对接受丘脑底核深部脑刺激（STN-DBS）的PD患者的长期认知结果的影响。方法：25例PD患者在基线时使用蒙特利尔认知评估（MoCA）进行神经心理学筛查，1年,和5年后双边STN-DBS。使用认知储备指数问卷评估CR。根据CR评分,患者被分为两组(LowCR组≤130,HighCR组>130).结果：我们的数据显示，与LowCR组相比，HighCR组的患者在长期随访中的MoCA总分获得了更好的表现（[平均值±SE]LowCR组：21.4±1.2vs.高CR组：24.5±1.3，p=0.05）。随着时间的推移，HighCR组的认知特征保持不变。相反，LowCR组术后5年的整体认知能力较差（T0：25.3±0.6vs.T2:21.4±1.2,p=0.02)。认知下降与情绪无关，人口统计，或临床变量。结论：这些初步发现表明，较高的CR可能对STN-DBS后的PD认知具有保护作用。具体来说,高CR可能有助于应对手术治疗的长期下降.量化患者的CR可能会导致更个性化的医疗护理，为认知能力下降风险较高的患者量身定制术后支持和监测。
