The impact of subthalamic deep brain stimulation on sleep and other non-motor symptoms in Parkinson's disease. (July 2019)

• Record Type: Journal Article
• Authors: Dulski, Jarosław; Schinwelski, Michał; Konkel, Agnieszka; Grabowski, Karol; Libionka, Witold; Wąż, Piotr; Sitek, Emilia J.; Sławek, Jarosław
• Is Part Of: Parkinsonism & related disorders. Volume 64(2019)
• Page Start: 138
• Page End: 144
• Publication Date: 2019-07
• Subjects: Parkinson's disease -- Deep brain stimulation -- Sleep -- Non-motor symptoms -- Quality of life; Parkinson's disease -- Periodicals; Movement disorders -- Periodicals; Movement Disorders -- Periodicals; Nerve Degeneration -- Periodicals; Nervous System Diseases -- Periodicals; Parkinson Disease -- Periodicals; Tremor -- Periodicals; Parkinson, Maladie de -- Périodiques; Parkinson's disease; 616.833
• DOI: 10.1016/j.parkreldis.2019.04.001
• Languages: English
• ISSNs: 1353-8020

Abstract

Abstract: Introduction: The non-motor symptoms have a major impact on quality of life in patients with Parkinson Disease (PD). We present results of the study on the impact of subthalamic deep brain stimulation (DBS-STN) on sleep and other non-motor symptoms in PD patients. Materials and methods: Thirty-six patients with advanced PD were included into the study. Twenty four were evaluated with two-night polysomnography (PSG) before surgery and at 6 months after DBS programming. The whole group (n = 36) was assessed using motor, non-motor symptoms (sleep disturbances in particular) and quality of life measures (QoL), before surgery, 6 and 12 months after DBS programming. Results: DBS-STN resulted in the significant deterioration of objective sleep parameters, as assessed by PSG, mostly in terms of total sleep time, sleep efficiency, duration of N1 and N2 sleep, wakefulness after sleep onset and sleep latency. At the same time, improvement in the subjective sleep measures, other non-motor symptoms (particularly fatigue, cardiovascular, gastrointestinal, and sexual symptoms) and QoL was identified. The subjective improvement of sleep, other non-motor symptoms and QoL was most prominent in the first 6 months after DBS-STN, diminished slightly (being still better than before surgery) after 12 months, in parallel to mood deterioration. Conclusion: DBS-STN resulted in the subjective sleep quality improvement with worsening of objective (PSG) sleep parameters after 6 months. After 12 months all sleep clinical outcome measures were still better than before surgery, albeit worse when compared to the first follow-up visit. Subjective sleep quality correlated positively with mood. Highlights: Subthalamic stimulation improves perceived sleep disturbances. Subthalamic stimulation improves non-motor symptoms and quality of life. Subthalamic stimulation may deteriorate objective sleep parameters. Subjective improvement is most prominent in the first few months after surgery. Subjective improvement after surgery corresponds to changes in mood over time.