Changes in Parkinson’s disease sleep symptoms and daytime somnolence after bilateral subthalamic deep brain stimulation in Parkinson’s disease

Kharkar, Siddharth; Ellenbogen, Jonathan R.; Samuel, Michael; Rizos, Alexandra; Silverdale, Monty; Ashkan, Keyoumars

doi:10.1038/s41531-018-0053-5

Cited by 17 publications

(16 citation statements)

References 49 publications

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“…More than half of the target population reported poor sleep quality on the subjective questionnaire used in the study. It is in accordance with the results of previous studies done on this topic 12,18 . It is an eye opener for the clinicians in our set up as neurologists usually miss this inquiry from the Parkinsonism patients and psychiatrists are seldom involved in the management of these patients in our set up.…”

Section: Discussionsupporting

confidence: 93%

“…Non probability consecutive sampling technique was used to gather the sample. Screening was performed on all the patients of PD between the age of 50 and 80 years reported for follow up visit or referred from other centers, diagnosed 11,12 at least 6 months ago by a consultant neurologist. Patients outside the designated age bracket, or those with previous significant psychiatric or substance use history or those delirious or had dementia at the time of interview were excluded from the study.…”

Section: Methodsmentioning

confidence: 99%

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Frequency and Correlates of Poor Sleep Quality Among Patients of Parkinson’s Disease

Kazmi

Hassan

Alamgir

et al. 2020

PAFMJ

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Objective: To determine the frequency of poor sleep quality among the patients of Parkinson’s disease (PD) and analyze its relationship with the socio-demographic factors.Study Design: Correlational study. Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi, from Jan 2019 to Jun 2019. Methodology: One hundred and fifty patients of Parkinson’s disease were approached to participate in this study. Pittsburgh sleep quality index (PSQI) was the psychometric tool used to assess the study parameter for the patients. Age, gender, duration of illness, poly pharmacy and tobacco smoking were corelated with presence of poor quality of sleep among the patients of Parkinson’s disease. Results: Out of 150 patients of Parkinson’s disease screened through Pittsburgh sleep quality index, 85 (56.7%)showed the presence of poor sleep quality while 65 (43.3%) had good sleep quality. Mean age of the patients was 66.2 ± 4.648 years. After applying the logistic regression, we found that increasing age and longer duration of illness had significant association with the presence of poor sleep quality among the patients of Parkinson disease. Conclusion: Previously considered a pure motor disorder, Parkinsonism has a lot of other neuro-psychiatricmanifestations as well. Poor sleep quality turned out to be one of these non-motor problems associated with this chronic debilitating illness. Increasing age and longer duration of illness among these patients emerged asindependent risk factors for poor sleep quality in Parkinsonism.

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Section: Discussionsupporting

confidence: 93%

Section: Methodsmentioning

confidence: 99%

Frequency and Correlates of Poor Sleep Quality Among Patients of Parkinson’s Disease

Kazmi

Hassan

Alamgir

et al. 2020

PAFMJ

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“…In 10 patients with 3 months of follow-up, PDSS showed improved sleep quality but, unlike our findings, without improvement of excessive daytime sleepiness 36 . In two other studies using PDSS, one showed improved scores for daytime sleepiness, sleep quality, and restless legs syndrome (n = 17) at 6 months postoperatively 37 , and the other showed significant improvements in PDSS after 6 months (n = 40) but not after 12 months (n = 26) 38 .…”

Section: Discussionmentioning

confidence: 94%

Subthalamic deep brain stimulation improves sleep and excessive sweating in Parkinson’s disease

Bjerknes

Skogseid

Hauge

et al. 2020

npj Parkinsons Dis.

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Parkinson’s disease (PD) is a complex multisystem disorder with motor and non-motor symptoms (NMS). NMS may have an even greater impact on quality of life than motor symptoms. Subthalamic nucleus deep brain stimulation (STN-DBS) has been shown to improve motor fluctuations and quality of life, whereas the effects on different NMS have been less examined. Sleep disturbances and autonomic dysfunction are among the most prevalent NMS. We here report the efficacy of STN-DBS on sleep disturbances and autonomic dysfunction. In the parent trial, 60 patients were included in a single-center randomized prospective study, with MDS-UPDRS III and PDQ-39 as primary endpoints at 12 months of STN-DBS. Preplanned assessments at baseline and postoperatively at 3 and 12 months also included Parkinson’s Disease Sleep Scale (PDSS); Scopa-Aut; and MDS-UPDRS I, II, and IV. We found that STN-DBS had a significant and lasting positive effect on overall sleep quality, nocturnal motor symptoms and restlessness, and daytime dozing. Several aspects of autonomic dysfunction were also improved at 3 months postoperatively, although at 12 months only thermoregulation (sudomotor symptoms) remained significantly improved. We could not identify preoperative factors that predicted improvement in PDSS or Scopa-Aut. There was a close relationship between improved autonomic symptoms and improved quality of life after 1 year. NMS and especially sleep and autonomic dysfunction deserve more focus to improve patient outcomes further.

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“…Improvement in sleep and pain was also observed in dystonia patients who were treated with STN DBS [75]. Interestingly, daytime sleepiness does not seem to be affected by DBS [76]. A possible reason for this could be a lacking effect on REM sleep, as DBS patients have an increased risk of developing REM sleep behavioral disorder in the case of STN stimulations [77].…”

Section: Sleepmentioning

confidence: 93%

Deep Brain Stimulation in Non-motor Symptoms of Neurodegenerative Diseases

Vuletić¹,

Rački²,

Chudy³

et al. 2020

Neurostimulation and Neuromodulation in Contemporary Therapeutic Practice

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Deep brain stimulation (DBS) is a functional neuromodulatory technique that involves the use of a neurostimulator to deliver electrical impulses to the brain. It primarily alleviates the motor symptoms in neurodegenerative diseases; however, it has been found beneficial in a multitude of neurological and psychiatric diseases, such as dystonia, essential tremor, Tourette syndrome, intractable pain, epilepsy, treatmentresistant depression, and obsessive-compulsive disorder. Nonmotor symptoms, such as neurobehavioral disorders, autonomic dysfunction, sleep dysfunction, and somatosensory dysfunction, play an important role in neurodegenerative diseases and have a significant impact on the quality of life. The effects of deep brain stimulation on these symptoms are not yet apparent, although early results are promising and warrant future investigations. The main problem in interpretation is the lack of studies in this field, as most have methodological issues or small sample sizes, which limit the strength of the evidence. However, it is clear that DBS has a promising future in the treatment of neurodegenerative diseases in general and will have a vital role in personalized medicine as functional neuroimaging and our understanding of brain physiology improve.2 becoming more apparent that neurostimulations will have an even more critical role in the future as our understanding of brain physiology and pathways improves with novel imaging techniques. This chapter includes the basics of how deep brain stimulation works, what are the nonmotor symptoms in neurodegenerative diseases, and what is the current evidence on the effects of DBS on nonmotor symptoms. Deep brain stimulation 2.1 How does deep brain stimulation work?The system for DBS consists of three key components: an electrode that is placed in specific cerebral structures, an implantable pulse generator (IPG), and an extension that connects the two. Even though the exact mechanism is not yet known, the current hypothesis is that DBS works via excitation and inhibition of neurons and axons that are in proximity of the placed electrode [5]. The desired effect is achieved by changing the frequency of stimulations, as low-frequency stimulations most often excite nearby neurons [1], while high-frequency stimulations reduce local neuronal activity. Details of the implantation procedure are beyond the scope of this chapter, although it is useful to know that it is implanted stereotactically. In most cases, the stimulation is bilateral, although it is possible to stimulate unilaterally as well. The targets for stimulation are deep brain structures, as well as deep white matter tracts.A key benefit of DBS is the ability to adjust stimulations wirelessly via handheld devices to improve symptom relief and reduce possible side effects [5].Currently used method for DBS function is based on an open-loop system, which enables trained physicians to adjust various settings depending on the patient's condition [6]. This works adequately for most patients; however, changes in patien...

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Changes in Parkinson’s disease sleep symptoms and daytime somnolence after bilateral subthalamic deep brain stimulation in Parkinson’s disease

Cited by 17 publications

References 49 publications

Frequency and Correlates of Poor Sleep Quality Among Patients of Parkinson’s Disease

Frequency and Correlates of Poor Sleep Quality Among Patients of Parkinson’s Disease

Subthalamic deep brain stimulation improves sleep and excessive sweating in Parkinson’s disease

Deep Brain Stimulation in Non-motor Symptoms of Neurodegenerative Diseases

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