Lower urinary tract symptoms and bladder control in advanced Parkinson's disease: Effects of deep brain stimulation in the subthalamic nucleus

Winge, Kristian; Nielsen, Kurt; Stimpel, Hans; Løkkegaard, Annemette; Jensen, Steen Rusborg; Werdelin, L.

doi:10.1002/mds.21253

Cited by 72 publications

(54 citation statements)

References 26 publications

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“…58,62,63 Deep brain stimulation of the subthalamic nucleus (DBS-STN) may also improve bladder function. [64][65][66] Studies of urodynamic bladder filling in patients treated with bilateral DBS-STN showed an improvement in the sensory deficit with normalization of their perception of urinary bladder filling.…”

Section: Bladdermentioning

confidence: 97%

Lesions outside the CNS in Parkinson's disease

2009

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Parkinson's disease (PD) is not a simple movement disorder induced just by loss of dopaminergic neurons in the substantia nigra pars compacta. Apparently, the substantia nigra is not the only or the first brain region damaged in PD. Moreover, older and recent studies have shown that the degenerative process in PD is much more extensive and affects not only the central nervous system (CNS) but also the peripheral autonomic nervous system and the organs outside the brain that the latter innervates. These include mainly the gastrointestinal tract, the heart, kidneys, urogenital system, and skin. Additional extra-CNS organs that are involved in PD include the eye and the adrenal gland. This article reviews the anatomical, physiological, and clinical features of extracerebral manifestations of PD, and describes their relevance to the etiology and pathogenesis of the disease. It establishes this illness as a systemic CNS and peripheral disorder that warrants new hypotheses regarding its causation and progression.

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Section: Bladdermentioning

confidence: 97%

Lesions outside the CNS in Parkinson's disease

2009

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“…68,69 A study has pointed out the maladjustment of some patients to the after-DBS life seems to be of multifactorial origin and warrants further study. 70 Some improvement in nonmotor symptoms has been reported, such as in constipation, 71 sleep, 71,72 sensory complaints, 72,73 and some bladder complaints, 74 as well as urodynamic parameters. 75 A randomized study has confirmed the superiority of STN DBS to medical management at 6 months followup.…”

Section: Beneficial Effectmentioning

confidence: 98%

Deep Brain Stimulation for Parkinson’s Disease

2008

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Summary:The surgical treatment of Parkinson's disease has been through a revival phase over the last 20 years with the development of deep brain stimulation (DBS). Thalamic DBS was developed first and has proven to be a very effective treatment for tremor. The limitation is the lack of effect on other symptoms. Other targets were therefore investigated, and the procedure was applied to the subthalamic nucleus (STN) and the internal globus pallidus (GPi). STN stimulation can improve a wide range of symptoms and is currently the preferred target for many patients. Nevertheless, the morbidity seems higher than with other targets, and the selection criteria have to be quite strict. When STN DBS is not advised, thalamic DBS remains an option for patients with severe tremor, and GPi stimulation for those with severe dyskinesias. DBS remains a symptomatic treatment for a limited number of patients; it does not seem to alter the disease progression, and many patients are not suitable. There is, therefore, the need for further research into other targets and other approaches.

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“…Similar results were found with the Dan-PSS score. The urodynamic parameter did not significantly change after surgery [22].…”

Section: Deep Brain Stimulationmentioning

confidence: 93%

Bladder Dysfunction and Parkinsonism: Current Pathophysiological Understanding and Management Strategies

2011

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Patients with Parkinson's disease (PD) commonly develop lower urinary tract symptoms (LUTS) as their disease severity progresses. It is a well-established fact that neurodegeneration of the nigrostriatal dopaminergic pathway occurs in PD. This neurochemical deficiency explains many of the motor disturbances encountered in patients with PD. However, the underlying cause of urinary dysfunction present in over half of patients with PD is poorly understood. Without clearly understanding the underlying pathophysiological and neurochemical mechanisms of LUTS associated with PD, treatment strategies are mainly empirical in nature. This review presents the most recent studies and evidence on the pathophysiological mechanisms of PD-related voiding dysfunction and its available therapies.

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Lower urinary tract symptoms and bladder control in advanced Parkinson's disease: Effects of deep brain stimulation in the subthalamic nucleus

Cited by 72 publications

References 26 publications

Lesions outside the CNS in Parkinson's disease

Lesions outside the CNS in Parkinson's disease

Deep Brain Stimulation for Parkinson’s Disease

Bladder Dysfunction and Parkinsonism: Current Pathophysiological Understanding and Management Strategies

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