Abstract Objective Telehealth-based neuropsychological assessment (Tele-NP) is validated across multiple patient populations and helps ensure clinical care access. However, the feasibility of Tele-NP compared to traditional in-office evaluations for deep brain stimulation (DBS) candidates with Parkinson’s disease (PD) is less understood. This study examines whether Tele-NP can substitute for in-office testing when evaluating PD-DBS candidates for cognitive outcome. Method We retrospectively reviewed charts of 82 patients with PD (age 64.4±9.1) who underwent routine neuropsychological assessment pre- and one-year post-DBS either in-office or via Tele-NP. Cognitive performance at each timepoint was compared between Tele-NP and in-office groups. To quantify post-surgical changes in test data, difference scores were calculated by subtracting post-surgical from pre-surgical scores regardless of treatment modality and then compared between those who remained in the same pre- and post-surgical testing modality (n=50) and those who switched modalities (n=32). Independent-samples t-tests assessed group differences, and Two One-Sided Tests (TOST) evaluated statistical equivalence using standardized z-scores. Results At both pre- and post-DBS timepoints, t-tests revealed no significant group differences across cognitive measures (all p-values .05), and TOST analyses demonstrated statistical equivalence across measures (all p-values .05). Cognitive difference scores did not differ between stable and switched modality groups (all p-values .05), and TOST confirmed equivalence for all difference scores (p .05). Conclusion Tele-NP is statistically equivalent to in-office assessments both before and after DBS surgery. Switching testing modalities between pre- and post-surgical evaluations did not impact scores on cognitive testing, supporting the clinical utility and flexibility of Tele-NP models.
Zhang et al. (Fri,) studied this question.