The Impact of Deep Brain Stimulation on the Quality of Life and Swallowing in Individuals with Parkinson's Disease

Abstract

Introduction Deep brain stimulation (DBS) is an established treatment for Parkinson's disease (PD). However, there is little evidence regarding the effect of DBS on dysphagia. Objective To assess the swallowing and quality of life of individuals with PD before and after DBS surgery. Methods Our sample consisted of people who had undergone DBS surgery in a referral hospital in the state of Rio Grande do Sul, Brazil. The inclusion criteria were a diagnosis of PD and having undergone DBS surgery. A cognitive screening, through a questionnaire about depression and quality of life, was conducted. Evaluations of each patient's swallowing were performed before and after surgery. The assessment consisted of anamnesis, clinical assessment, the Functional Oral Intake Scale, clinical evaluation of swallowing, and the Hoehn and Yahr scale. Results The sample included 10 individuals, all male, with a mean age of 57.3 years (±4.7), a mean disease duration of 13.0 years (±2.4), and mean level education of 8.1 years (±4.0). In the clinical evaluation of the swallowing, a significant improvement after DBS was not observed. However, little changes in the signs and symptoms of dysphagia that had a positive impact on the quality of life were observed. Furthermore, there was no relation between the patients' motor subtype and swallowing pre- and post-DBS. Conclusion There was an improvement in the quality of life of the patients after DBS. However, the improvement in the clinical signs and symptoms of dysphagia did not cause an overall improvement in the swallowing function.

Effect of Deep Brain Stimulation on Swallowing Function: A Systematic Review

“…STN DBS in patients with PD can have no effects ( 36 – 38 ). Kitashima et al reported no improvement in swallowing function in 18 PD patients assessed by VFSS at ON medication state 6 months after the bilateral STN DBS ( 37 ).…”

“…Kitashima et al reported no improvement in swallowing function in 18 PD patients assessed by VFSS at ON medication state 6 months after the bilateral STN DBS ( 37 ). Olchik et al found no change in swallowing function 6 months after bilateral STN DBS in 10 PD patients assessed by anamnesis, functional oral intake scale, and clinical swallowing function ( 38 ).…”

“…STN DBS in patients with PD can have no effects (36)(37)(38). Kitashima et al reported in 10 PD patients assessed by anamnesis, functional oral intake scale, and clinical swallowing function (38).…”

Efeitos da estimulação cerebral profunda em pacientes com doença de Parkinson: uma revisão da literatura

“…A bradicinesia é caracterizada por uma desaceleração dos movimentos associada a rigidez e tremor, sendo considerada um dos sintomas característicos da DP. Tal sintoma está relacionado a um aumento na sincronização das oscilações nas faixas de baixa frequência (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30). Nesse sentido, a terapia de estimulação de alta frequência é uma opção eficaz para pacientes com DP, já que ocorre a modulação da atividade oscilatória anormal nos núcleos subtalâmicos (KÜHN AA, et al, 2008).…”

Challenges in Scaling Down of Free-Floating Implantable Neural Interfaces to Millimeter Scale

“…In the field of medicine, more effective and personalized disease prevention, diagnosis, prognosis, and treatment can be achieved with continuous monitoring of neural signals. Therapeutic electrical stimulation, the induced alternation of brain activity through delivering electrical impulses to targeted brain areas, has been regarded as an effective therapy for treating Parkinson's disease [1], essential tremor [2], dystonia [3], obsessive-compulsive disorder (OCD), major depressive disorder (MDD) [4], and epilepsy [5]. More recently, brain-computer interface (BCI) or brain-machine interface (BMI) has been developed as motor neuroprosthetic device [6], [7], which could significantly promote the quality of life for those with serious motor impairments, such as spinal cord injury, stroke, and limb loss [8].…”