Beneficial effect of 24-month bilateral subthalamic stimulation on quality of sleep in Parkinson’s disease

Dafsari, Haidar S.; Ashkan, Keyoumars; Sachse, Lena; Mahlstedt, Picabo; Silverdale, Monty; Rizos, Alexandra; Strack, Marian; Jost, Stefanie T.; Reker, Paul; Samuel, Michael; Visser‐Vandewalle, Veerle; Evans, Julian; Antonini, Angelo; Martinez‐Martín, Pablo; Timmermann, Lars

doi:10.1007/s00415-020-09743-1

Cited by 22 publications

(16 citation statements)

References 48 publications

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“…The screening of PD patients for sleep disorders with validated questionnaires appears to be useful to identify those patients with clinically relevant sleep disorders, possibly associated with a greater degree of cognitive impairment, even in the absence of a polysomnographic assessment, which is not always readily available in clinical practice. Moreover, our data confirm that screening for sleep disorders is also suitable in the context of patient selection for device-aided therapies, given the reduction of sleep alterations after both deep brain stimulation and LCIG infusion [35,36], with a consequent improvement of patients' quality of life.…”

Section: Discussionsupporting

confidence: 72%

Association between sleep disorders and cognitive dysfunctions in non-demented patients with advanced Parkinson’s disease

et al. 2021

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Background Parkinson’s disease (PD) is increasingly recognized as a multidimensional disorder, characterized by several non-motor symptoms, including disturbances of sleep and cognition. Current studies on the relationship between sleep problems and neuropsychological functions, mainly conducted in early to moderate PD patients, outline mixed results. In this study, we analysed the relationship between subjectively reported sleep alterations and cognitive functions in a large cohort of 181 advanced PD patients. Methods All consecutive, non-demented, advanced PD patients candidates for device-aided therapy completed two self-administered sleep questionnaires—the Parkinson’s Disease Sleep Scale (PDSS-2) and the Epworth Sleepiness Scale (ESS)—and underwent a comprehensive battery of neuropsychological tests encompassing five cognitive domains (reasoning, memory, attention, frontal executive functions, and language). Results Patients showed mild to moderate sleep problems (PDSS-2 score: 23.4 ± 1.2) and mild daytime sleepiness (ESS 8.6 ± 5.1). A significant correlation was found between PDSS-2 total score and non-verbal reasoning, as well as attentive skills, executive functions, and language abilities. No correlations were found between sleep measures and memory tests scores. Patients with clinically relevant sleep disturbances performed worse on attention, executive functions, and language. No significant correlations were found between daytime sleepiness and any neuropsychological test. Conclusions In advanced PD patients, sleep disturbances selectively correlate with specific neuropsychological functions and not with short-term memory and consolidation. Even if confirmations by means of longitudinal studies are needed, our observations suggest the importance of considering treatment of sleep disturbances to minimize their potential impact on cognition.

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Section: Discussionsupporting

confidence: 72%

Association between sleep disorders and cognitive dysfunctions in non-demented patients with advanced Parkinson’s disease

et al. 2021

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“…Globally, improvements in TST and sleep efficiency, reductions in WASO, and subjective improvements in sleep quality and insomnia have been noted after DBS. [185][186][187][188][189][190][191][192][193][194][195][196][197][198] Several studies have also found specific increases in total REM sleep, [199][200][201] whereas 1 study also found improvement in time spent in SWS but not REM. 195 These improvements after DBS seem enduring, as the largest long-term follow-up study showed sustained improvements in subjective sleep quality 3 years after bilateral STN DBS implantations in patients with PD.…”

Section: Effect Of Conventional Dbs On Sleepmentioning

confidence: 99%

The Neurophysiology of Sleep in Parkinson's Disease

et al. 2021

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Sleep disturbances are among the most common nonmotor complications of Parkinson's disease (PD), can present in prodromal stages, and progress with advancing disease. In addition to being a symptom of neurodegeneration, sleep disturbances may also contribute to disease progression. Currently, limited options exist to modulate sleep disturbances in PD. Studying the neurophysiological changes that affect sleep in PD at the cortical and subcortical level may yield new insights into mechanisms for reversal of sleep disruption. In this article, we review cortical and subcortical recording studies of sleep in PD with a particular focus on dissecting reported electrophysiological changes. These studies show that slow-wave sleep and rapid eye movement sleep are both notably disrupted in PD. We further explore the impact of these electrophysiological changes and discuss the potential for targeting sleep via stimulation therapy to modify PD-related motor and nonmotor symptoms.

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“…(1) QoL was investigated with the PD Questionnaire-8 (PDQ-8) reported as PDQ-8 Summary Index (PDQ-8 SI) ranging from 0 (no impairment) to 100 (maximum impairment) 31,32 . The PDQ-8 assesses eight aspects of QoL (mobility, activities of daily living, emotional wellbeing, stigma, social support, cognition, communication, bodily discomfort) and has been commonly used in PD 33 and STN-DBS 28,34,35 Linear regression analysis. In a second step, we aimed to identify preoperative predictors of long-term QoL outcome using stepwise linear regression analysis.…”

Section: Clinical Assessmentmentioning

confidence: 99%

Non-motor predictors of 36-month quality of life after subthalamic stimulation in Parkinson disease

Jost

Visser-Vandewalle

Rizos

et al. 2021

npj Parkinsons Dis.

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To identify predictors of 36-month follow-up quality of life (QoL) outcome after bilateral subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson’s disease (PD). In this ongoing, prospective, multicenter international study (Cologne, Manchester, London) including 73 patients undergoing STN-DBS, we assessed the following scales preoperatively and at 6-month and 36-month follow-up: PD Questionnaire-8 (PDQ-8), NMSScale (NMSS), Scales for Outcomes in PD (SCOPA)-motor examination, -activities of daily living, and -complications, and levodopa equivalent daily dose (LEDD). We analyzed factors associated with QoL improvement at 36-month follow-up based on (1) correlations between baseline test scores and QoL improvement, (2) step-wise linear regressions with baseline test scores as independent and QoL improvement as dependent variables, (3) logistic regressions and receiver operating characteristic curves using a dichotomized variable “QoL responders”/“non-responders”. At both follow-ups, NMSS total score, SCOPA-motor examination, and -complications improved and LEDD was reduced significantly. PDQ-8 improved at 6-month follow-up with subsequent decrements in gains at 36-month follow-up when 61.6% of patients were categorized as “QoL non-responders”. Correlations, linear, and logistic regression analyses found greater PDQ-8 improvements in patients with younger age, worse PDQ-8, and worse specific NMS at baseline, such as ‘difficulties experiencing pleasure’ and ‘problems sustaining concentration’. Baseline SCOPA scores were not associated with PDQ-8 changes. Our results provide evidence that 36-month QoL changes depend on baseline neuropsychological and neuropsychiatric non-motor symptoms burden. These findings highlight the need for an assessment of a wide range of non-motor and motor symptoms when advising and selecting individuals for DBS therapy.

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Beneficial effect of 24-month bilateral subthalamic stimulation on quality of sleep in Parkinson’s disease

Cited by 22 publications

References 48 publications

Association between sleep disorders and cognitive dysfunctions in non-demented patients with advanced Parkinson’s disease

Association between sleep disorders and cognitive dysfunctions in non-demented patients with advanced Parkinson’s disease

The Neurophysiology of Sleep in Parkinson's Disease

Non-motor predictors of 36-month quality of life after subthalamic stimulation in Parkinson disease

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