Improvement of sleep quality in patients with advanced Parkinson's disease treated with deep brain stimulation of the subthalamic nucleus

Abstract

Most Parkinson's patients complain about sleep problems. The subjective effect of deep brain stimulation (DBS) of the subthalamic nucleus (STN) on nocturnal disabilities and sleep quality was elucidated by the recently established Parkinson's disease sleep scale (PDSS). The DBS-treated group obtained significant improvement of motor function assessed by the Unified Parkinson's Disease Rating Scale. The mean total PDSS improved significantly after surgery whereas no change was found for the control group. Significant improvements of individual questions were obtained for overall sleep quality and motor symptoms whereas nocturia and daytime sleepiness did not change despite significant reduction of parkinsonian medication.

Nonmotor manifestations of Parkinson's disease

“…Several authors reported an improvement in nocturnal sleep in PD patients who underwent deep brain stimulation. 146,147 The impact of deep brain stimulation on EDS, however, has not been systematically studied.…”

The Impact of Subthalamic Deep Brain Stimulation on Sleep–Wake Behavior: A Prospective Electrophysiological Study in 50 Parkinson Patients

“…In studies examining subjective sleep quality after subthalamic stimulation, overall sleep quality and total sleep time improved after STN-DBS. 3,4,5 To date, most studies including objective polysomnographic measures have been small case series, with different patient populations, study protocols, various assessment time points, and electrode settings: Arnulf and colleagues evaluated 10 insomniac PD patients 3 to 6 months after STN-DBS, and found stimulation to increase total sleep time and sleep efficiency. 6 Similar findings have been made by Monaca et al in 10 patients before STN-DBS and again after 3 months, 7 by Cicolin and colleagues in 5 patients before and 3 months after bilateral STN-DBS electrode implantation, 8 and by Merlino et al in 15 patients one week before and after microsubthalamotomy.…”

Morning akinesia in Parkinson's disease: challenges and solutions

“…61 Another small study reported improvements in sleep architecture and quality, along with an increase in total sleep time (up to 47%) even in patients treated with subthalamic nuclei (STN) deep brain stimulation (DBS). 62,63 Moreover, an alleviation of "OFF" dystonia was registered after the microlesion effect produced by STN DBS surgical intervention. In this group of 30 patients, the morning of the third day following STN implantation, after at least a 12-hour withdrawal of dopaminergic treatment and before the programmable pulse generator was switched on, a significant clinical improvement was observed.…”