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

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, where...

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Autores principales: Bjerknes, Silje, Skogseid, Inger Marie, Hauge, Tuva Jin, Dietrichs, Espen, Toft, Mathias
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7560751/
https://www.ncbi.nlm.nih.gov/pubmed/33083523
http://dx.doi.org/10.1038/s41531-020-00131-0
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author Bjerknes, Silje
Skogseid, Inger Marie
Hauge, Tuva Jin
Dietrichs, Espen
Toft, Mathias
author_facet Bjerknes, Silje
Skogseid, Inger Marie
Hauge, Tuva Jin
Dietrichs, Espen
Toft, Mathias
author_sort Bjerknes, Silje
collection PubMed
description 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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spelling pubmed-75607512020-10-19 Subthalamic deep brain stimulation improves sleep and excessive sweating in Parkinson’s disease Bjerknes, Silje Skogseid, Inger Marie Hauge, Tuva Jin Dietrichs, Espen Toft, Mathias NPJ Parkinsons Dis Article 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. Nature Publishing Group UK 2020-10-14 /pmc/articles/PMC7560751/ /pubmed/33083523 http://dx.doi.org/10.1038/s41531-020-00131-0 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Bjerknes, Silje
Skogseid, Inger Marie
Hauge, Tuva Jin
Dietrichs, Espen
Toft, Mathias
Subthalamic deep brain stimulation improves sleep and excessive sweating in Parkinson’s disease
title Subthalamic deep brain stimulation improves sleep and excessive sweating in Parkinson’s disease
title_full Subthalamic deep brain stimulation improves sleep and excessive sweating in Parkinson’s disease
title_fullStr Subthalamic deep brain stimulation improves sleep and excessive sweating in Parkinson’s disease
title_full_unstemmed Subthalamic deep brain stimulation improves sleep and excessive sweating in Parkinson’s disease
title_short Subthalamic deep brain stimulation improves sleep and excessive sweating in Parkinson’s disease
title_sort subthalamic deep brain stimulation improves sleep and excessive sweating in parkinson’s disease
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7560751/
https://www.ncbi.nlm.nih.gov/pubmed/33083523
http://dx.doi.org/10.1038/s41531-020-00131-0
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