Parkinson’s disease: deep brain stimulation improves non-motor symptoms as well as motor symptoms


Deep brain stimulation ( DBS ) has become a well-recognized nonpharmacologic treatment that improves motor symptoms of patients with early and advanced Parkinson’s disease.
Evidence now indicates that Deep brain stimulation can decrease the number and severity of non-motor symptoms of patients with Parkinson’s disease ( PD ).

Non-motor features are common in PD patients, occur across all disease stages, and while well described, are still under-recognized when considering their huge impact on patients’ quality of life.

According to Lisa Klingelhoefer, at King’s College Hospital and King’s College, London ( UK ), deep brain stimulation of the subthalamic nucleus ( STN ) is effective for alleviating sleep problems and fatigue associated with Parkinson’s disease, producing noticeable long-term improvements in sleep efficiency and the quality and duration of continuous sleep.
Deep brain stimulation also decreases nighttime and early morning dystonia and improves nighttime mobility. Deep brain stimulation can contribute to better sleep, less daytime somnolence, improved mobility, and less need for dopamine replacement therapy.

The effects of deep brain stimulation on some other non motor symptoms of Parkinson’s disease are less clear cut and transient worsening of neuropsychological and psychiatric symptoms have been reported.
Behavioral disorders such as impulsivity ( e.g. hypersexuality, pathological gambling, and excessive eating ) can occur or worsen in PD patients after STN deep brain stimulation.
While pre-existing drug-induced psychotic symptoms like hallucinations often disappear after STN deep brain stimulation, transient psychotic symptoms such as delirium may emerge in the immediate post-operative period.
Similarly, conflicting reports have found that STN deep brain stimulation improves, worsens, or does not change mood disorders such as depression, mania, or anxiety.

Further work is required in order to fully understand the mechanisms and impact of deep brain stimulation of the STN or other brain structures on the non motor symptoms of Parkinson’s disease. ( Xagena )
Source: Journal of Parkinson's Disease, 2014

XagenaMedicine_2014



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