Sleep symptoms and polysomnographic architecture in advanced Parkinson's disease after chronic bilateral subthalamic stimulation

Iranzo, Álex; Valldeoriola, Francesc; Santamaría, Joan; Tolosa, Eduard; Rumià, Jordi

doi:10.1136/jnnp.72.5.661

Cited by 158 publications

(102 citation statements)

References 15 publications

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“…Polysomnographic sleep parameters disturbances associated with PD are poor sleep efficiency, a decrease in the quantity of N3 sleep, and R sleep 29 . In our patients, total N3 sleep was low but was not considered a clinical significant finding due to the fact that N3 diminishes with age.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and correlates of sleep disorders in Parkinson’s disease: a polysomnographic study

Alatriste-Booth

Rodríguez-Violante

Camacho-Ordóñez

et al. 2015

Arq. Neuro-Psiquiatr.

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Objective: Sleep disorders in Parkinson's disease are very common. Polysomnography (PSG) is considered the gold standard for diagnosis. The aim of the present study is to assess the prevalence of nocturnal sleep disorders diagnosed by polysomnography and to determine the associated clinical factors. Method: A total of 120 patients with Parkinson's disease were included. All patients underwent a standardized overnight, single night polysomnography. Results: Ninety-four (78.3%) patients had an abnormal PSG. Half of the patients fulfilled criteria for sleep apnea-hypopnea syndrome (SAHS); rapid eye movement behavior disorder (RBD) was present in 37.5%. Characteristics associated with SAHS were age (p = 0.049) and body mass index (p = 0.016). Regarding RBD, age (p , 0.001), left motor onset (p = 0.047) and levodopa equivalent dose (p = 0.002) were the main predictors. Conclusion: SAHS and RBD were the most frequent sleep disorders. Higher levodopa equivalent dose and body mass index appear to be risk factors for RBD and SAHS, respectively.Keywords: Parkinson's disease, sleep disorders, polysomnography. RESUMOObjetivo: Os distúrbios do sono na doença de Parkinson são muito comuns. A polissonografia é considerada o padrão-ouro para o diagnóstico. O objetivo do presente estudo é avaliar a prevalência de distúrbios de sono noturno diagnosticados por polissonografia. Método: 120 pacientes com doença de Parkinson foram incluídos. Todos os pacientes foram submetidos a uma única noite, polissonografia de noite. Resultados: 94 (78,3%) pacientes tiveram uma polissonografia anormal e 50% preencheram a síndrome da apneia e hipopneia do sono (SAHOS); distúrbio de comportamento do movimento rápido dos olhos (RBD) esteve presente em 37,5%. As características associadas com SAHOS foram idade (p = 0,049) e índice de massa corporal (p = 0,016). Quanto RBD, idade (p , 0,001), deixou início motor (p = 0,047) e levodopa dose equivalente (p = 0,002) foram os preditores. Conclusão: SAHOS e RBD foram os distúrbios do sono mais frequente. Dose superior equivalente de levodopa e índice de massa corporal parecem ser fatores de risco, respectivamente.Palavras-chave: doença de Parkinson, distúrbios do sono, polissonografia.

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Section: Discussionmentioning

confidence: 99%

Prevalence and correlates of sleep disorders in Parkinson’s disease: a polysomnographic study

Alatriste-Booth

Rodríguez-Violante

Camacho-Ordóñez

et al. 2015

Arq. Neuro-Psiquiatr.

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“…Three Class III studies using PSG found an improvement in sleep quality following DBS of the STN. [32][33][34] In one study, total sleep time increased from a mean of 281 minutes before DBS to a mean of 360 minutes after DBS (with DBS on), an improvement of 28%. 32 Other studies showed a significant decrease in the arousal index from 18.0 to 11.2 (38%), 33 and total sleep efficiency increased by a mean of 36%.…”

mentioning

confidence: 99%

“…[32][33][34] In one study, total sleep time increased from a mean of 281 minutes before DBS to a mean of 360 minutes after DBS (with DBS on), an improvement of 28%. 32 Other studies showed a significant decrease in the arousal index from 18.0 to 11.2 (38%), 33 and total sleep efficiency increased by a mean of 36%. 36 A Class I study found that levodopa/carbidopa administered at bedtime decreased the frequency of spontaneous movements in bed from 43/night to 28 -33/night.…”

mentioning

confidence: 99%

Practice Parameter: Treatment of nonmotor symptoms of Parkinson disease [RETIRED]

et al. 2010

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Objective: Nonmotor symptoms (sleep dysfunction, sensory symptoms, autonomic dysfunction, mood disorders, and cognitive abnormalities) in Parkinson disease (PD) are a major cause of morbidity, yet are often underrecognized. This evidence-based practice parameter evaluates treatment options for the nonmotor symptoms of PD. Articles pertaining to cognitive and mood dysfunction in PD, as well as treatment of sialorrhea with botulinum toxin, were previously reviewed as part of American Academy of Neurology practice parameters and were not included here. Methods:A literature search of MEDLINE, EMBASE, and Science Citation Index was performed to identify clinical trials in patients with nonmotor symptoms of PD published between 1966 and August 2008. Articles were classified according to a 4-tiered level of evidence scheme and recommendations were based on the level of evidence. Results and Recommendations:Sildenafil citrate (50 mg) may be considered to treat erectile dysfunction in patients with Parkinson disease (PD) (Level C). Macrogol (polyethylene glycol) may be considered to treat constipation in patients with PD (Level C). The use of levodopa/carbidopa probably decreases the frequency of spontaneous nighttime leg movements, and should be considered to treat periodic limb movements of sleep in patients with PD (Level B). There is insufficient evidence to support or refute specific treatments for urinary incontinence, orthostatic hypotension, and anxiety (Level U). Future research should include concerted and interdisciplinary efforts toward finding treatments for nonmotor symptoms of PD. Neurology The Quality Standards Subcommittee (QSS) of the American Academy of Neurology (AAN) develops scientifically sound, clinically relevant practice parameters to aid in the practice of neurology. This article evaluates treatment options for nonmotor symptoms of Parkinson disease (PD).While PD is considered a disorder characterized by motor symptoms, nonmotor symptoms are an integral part of this syndrome. These symptoms can be as troublesome as motor symptoms and impact activities of daily living, though they are often underrecognized by health care professionals.1,2 The nonmotor symptoms reviewed for this guideline were autonomic dysfunction (gastrointestinal disorders, orthostatic hypotension, sexual dysfunction, urinary incontinence), sleep disorders (restless legs syndrome, periodic limb movements of sleep, excessive daytime somnolence, insomnia, REM sleep behavior disorder), fatigue, and anxiety. Articles pertaining to cognitive and mood dysfunction in PD, as well as treatment of sialorrhea with botulinum toxin, were reviewed as part of previous AAN practice parameters 3,4 and were not included here.

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“…Response of RLS symptoms in PD patients following STN DBS and pallidotomy has been reported (5,10,13). However, polysomnography studies measuring the PLM index in PD patients who have undergone STN DBS have been variable (2,4,6). The marked reduction in contralateral movements and nearly immediate reversibility of the observed effect in this patient with intraoperative stimulation suggest that perhaps PLM may be potentially responsive to GPi DBS.…”

Section: Discussionmentioning

confidence: 76%

Bilateral globus pallidus internus deep brain stimulation in parkinson’s disease with periodic limb movement disorder

Klassen

Lyons

Evidente

2011

Turkish Neurosurgery

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ÖZParkinson hastalığı için derin beyin stimülasyonu refrakter hastalıkta iyi yerleşmiş bir terapötik girişimdir. Ana nükleer hedefler subtalamik nükleus ve globus pallidus internustur. Periyodik uzuv hareketleri Parkinson hastalıklı hastalarda sıklıkla ilişkili olarak görülen bir durumdur. Her iki durum dopaminerjik ajanlara cevap verebilir. Burada şiddetli Parkinson hastalığı ve periyodik uzuv hareketi olan ve Parkinson hastalığı için bilateral globus pallidus derin beyin stimülasyonu cerrahisi yapılan 57 yaşında bir erkek hastayı sunuyoruz. İntraoperatif olarak hastanın periyodik uzuv hareketleri, Parkinson belirtilerinin düzelmesi için gerekli olandan daha yüksek voltaj stimülasyonuna cevap verdi. Stimülasyon bölgesine kontralateral bu belirtilerin anında ve geri çevrilebilir şekilde düzelmesi pallidal stimülasyonun periyodik uzuv hareketi belirtilerini doğrudan iyileştirebileceğini düşündürmektedir.

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Sleep symptoms and polysomnographic architecture in advanced Parkinson's disease after chronic bilateral subthalamic stimulation

Cited by 158 publications

References 15 publications

Prevalence and correlates of sleep disorders in Parkinson’s disease: a polysomnographic study

Prevalence and correlates of sleep disorders in Parkinson’s disease: a polysomnographic study

Practice Parameter: Treatment of nonmotor symptoms of Parkinson disease [RETIRED]

Bilateral globus pallidus internus deep brain stimulation in parkinson’s disease with periodic limb movement disorder

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