Cognitive outcomes of deep brain stimulation depend on age and hippocampal connectivity in Parkinson's and Alzheimer's disease
Bibliographic record
Abstract
INTRODUCTION: Here we contrast cognitive outcomes of deep brain stimulation (DBS) in Parkinson's disease (PD) with Alzheimer's disease (AD) to isolate the shared effect of DBS upon cognition while filtering out disease-specific effects. Based on prior literature, we evaluate how DBS connectivity to the hippocampus influences cognition. We then evaluate how patient factors moderate this relationship. METHODS: We studied electrode locations and cognitive outcomes in patients who received subthalamic nucleus (STN) DBS for PD (2 datasets: n = 33, n = 28) or fornix DBS for AD (1 dataset: n = 46). We then investigate the moderating effect of patient factors and similarities across diseases. RESULTS: DBS site connectivity to the hippocampus was cognitively deleterious in PD but beneficial in AD. The opposite findings were driven by patient age. This effect was mediated by age-related hippocampal atrophy. DISCUSSION: The shared cognitive effects of DBS across PD and AD depend on hippocampal connectivity and age. HIGHLIGHTS: Cognition can be positively or negatively modulated in the same manner across diseases. Contrary to current clinical practice, older Parkinson's disease (PD) patients may benefit from deep brain stimulation (DBS). Our results support limiting enrollment to patients over 65 for Alzheimer's disease (AD) DBS, an emerging therapy currently in a phase 3 clinical trial. Hippocampal volume mediates the impact of DBS, suggesting patient atrophy must be considered in patient-specific care.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".