Cortical thickness and cognitive decline in Parkinson patients with deep brain stimulation in the MARK-PD study

Advanced Parkinsons disease (PD) and deep brain stimulation (DBS) are associated with cognitive impairment. We aimed to evaluate whether regional cortical thickness is associated with cognitive decline in patients with advanced PD treated with DBS. From the MARK-PD study, 32 patients with DBS implantation were included. Cortical thickness of 148 brain areas and cognitive function were assessed with MRI data using the FreeSurfer pipeline and Montreal Cognitive Assessment at baseline and follow-up (median 17 months), respectively. Adjusted linear and Cox regression models were calculated. Thinner orbitofrontal, cingulate, and occipito-temporal cortices as well as cuneus is related to significant cognitive decline. Moreover, lower thickness of these cortices is also associated with faster cognitive decline. Our study suggests that PD patients treated with DBS and lower cortical thickness in multiple brain regions develop at stronger and faster cognitive decline during the later course of the disease.