BACKGROUND White matter hyperintensities (WMHs) in the cholinergic pathways are associated with cognitive impairment in Parkinson's disease (PD). This study aimed to investigate the role of WMHs within the cholinergic pathways in cognitive performance following bilateral subthalamic nucleus deep brain stimulation (STN DBS) in patients with PD. METHODS 38 patients with PD who underwent bilateral STN DBS were assessed using the Cholinergic Pathways Hyperintensities Scale (CHIPS) with magnetic resonance imaging before surgery. Their cognitive statuses were evaluated pre-surgically and 6 months, 1 year, and 2 years post operation. The correlations between the CHIPS score and cognitive performance were analyzed. The differences in cognitive performance before and after the surgery between the high-CHIPS and low-CHIPS groups were also compared. RESULTS The CHIPS score in patients with PD negatively correlated with the general cognition assessed using Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) both at baseline and after DBS. No correlation was found between the CHIPS score and the change of MMSE and MoCA scores after DBS. No significant difference was observed in the change in cognitive performance after the surgery between the high and low-CHIPS groups. CONCLUSION The severity of cholinergic WMHs was correlated with the cognition in patients with PD both before and after the STN DBS. However, it does not correlate with the cognitive change in patients with PD after bilateral STN-DBS.

中文翻译：

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帕金森病患者双侧 STN DBS 后胆碱能通路中的白质高信号和认知表现

背景胆碱能通路中的白质高信号 (WMH) 与帕金森病 (PD) 的认知障碍有关。本研究旨在研究 WMH 在胆碱能通路中对 PD 患者双侧丘脑深部脑刺激 (STN DBS) 后认知能力的作用。方法 38 名接受双侧 STN DBS 的 PD 患者在手术前使用胆碱能通路高信号量表 (CHIPS) 和磁共振成像进行评估。他们的认知状态在术前和术后 6 个月、1 年和 2 年进行了评估。分析了 CHIPS 评分与认知能力之间的相关性。还比较了高CHIPS组和低CHIPS组在手术前后认知表现的差异。结果 PD 患者的 CHIPS 评分与基线和 DBS 后使用简易精神状态检查 (MMSE) 和蒙特利尔认知评估 (MoCA) 评估的一般认知呈负相关。未发现 CHIPS 评分与 DBS 后 MMSE 和 MoCA 评分变化之间存在相关性。高、低 CHIPS 组在手术后认知能力的变化没有观察到显着差异。结论 胆碱能 WMHs 的严重程度与 PD 患者在 STN DBS 前后的认知相关。然而，它与双侧 STN-DBS 后 PD 患者的认知改变无关。