Effects of bilateral stimulation of the subthalamic nucleus in Parkinson's disease with and without REM sleep behaviour disorder

Aug 19, 2019Journal of neurology, neurosurgery, and psychiatry

Effects of stimulating both sides of the movement control area in Parkinson’s disease with and without REM sleep behavior disorder

AI simplified

Circadian Biology on OpenScience ↗PubMed ↗DOI ↗

Abstract

Among 50 Parkinson's disease patients, 48% had rapid eye movement sleep behavior disorder.

Pre-deep brain stimulation (DBS), the clinical profiles of patients with and without rapid eye movement sleep behavior disorder (RBD) differed significantly.
Key factors distinguishing the groups included motor function, apathy, and depression scores.
Post-DBS, improvements were noted in motor function, sleepiness, and quality of life for both groups.
The PD patients with RBD experienced a significant improvement in their activities of daily living compared to those without RBD.
Depressive symptoms improved in patients with RBD after DBS, while they remained unchanged in those without RBD.
Apathy levels increased in patients without RBD, while remaining stable in those with RBD.

AI simplified

BACKGROUND: Although rapid eye movement sleep behaviour disorder (RBD) in Parkinson's disease (PD) is associated with increased non-motor symptoms, its impact on the deep brain stimulation (DBS) outcome remains unclear. This is the first study to compare the post-DBS outcome between PD patients with RBD (PD-RBD+) and without (PD-RBD-).

METHODS: We analysed data from PD patients who were treated with bilateral DBS in the nucleus subthalamicus. Assessments included night-polysomnography (only pre-DBS), and motor and non-motor assessments pre-DBS and post-DBS.

RESULTS: Among 50 PD patients (29 males, mean age 62.5 years, 11.8 mean PD years), 24 (48%) had RBD. Pre-DBS, the two groups were equal in respect to sociodemographic features, disease duration and PD medications. A multivariate analysis showed that the clinical profile linked to motor, non-motor and quality of life features differed significantly between PD patients with and without RBD. The most discriminative elements were Unified Parkinson's Disease Rating Scale (UPDRS)-III, apathy and depression scores. Post-DBS, UPDRS-III, Epworth sleepiness scale and PD questionnaire improved significantly in both groups. UPDRS-II scores significantly improved in the PD-RBD+ group (-45%) but remained unchanged in the PD-RBD- group (-14%). The depression score improved significantly in the PD-RBD+ (-34%) and remained unchanged in the PD-RBD- group. The apathy score remained unchanged in the PD-RBD+ group but increased significantly in the PD-RBD- group (+33%).

CONCLUSION: While pre-DBS, PD patients with and without RBD showed different clinical profiles, post-DBS, the clinical profiles were comparable between the two groups. In respect to depressive symptoms, apathy and activities of daily living, PD-RBD+ patients show favourable post-DBS outcome. These findings highlight the importance of RBD assessment prior to DBS surgery.

Full Text

Full text is available at the source.

View full text ↗

Effects of bilateral stimulation of the subthalamic nucleus in Parkinson's disease with and without REM sleep behaviour disorder

Abstract

Full Text

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the circadian biology brief

Abstract

Full Text

Related papers

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the circadian biology brief