STUDY OBJECTIVE: Sleep disorders are frequent non-motor symptoms in Parkinson disease (PD), probably due to multifactorial pathogeneses including disease progression, dopaminergic drugs, or concomitant illness. In recent years, the pedunculopontine tegmental (PPTg) nucleus has been considered a surgical target for deep brain stimulation (DBS) in advanced PD patients. As it is involved in controlling the sleep-wake cycle, we investigated the long-lasting effects of PPTg-DBS on the sleep of five PD patients implanted in both the PPTg and the subthalamic nucleus (STN) by rating two subjective clinical scales for sleep: the Parkinson's Disease Sleep Scale (PDSS), and the Epworth Sleepiness Scale (ESS). STUDY DESIGN: Sleep scales were administered a week before surgery (T0), three months after DBS (T1), and one year later (T2). In this study, STN-DBS was kept constantly in ON, and three different patterns of PPTg-DBS were investigated: STN-ON (PPTg switched off); PPTg-ON (PPTg stimulated 24 h/day); PPTg-cycle (PPTg stimulated only at night). RESULTS: In post-surgery follow-up, PD patients reported a marked improvement of sleep quality in all DBS conditions. In particular, stimulation of the PPTg nucleus produced not only a remarkable long-term improvement of nighttime sleep, but unlike STN-DBS, also produced significant amelioration of daytime sleepiness. CONCLUSION: Our study suggests that PPTg-DBS plays an important role in reorganizing regular sleep in PD patients.
STUDY OBJECTIVE: Sleep disorders are frequent non-motor symptoms in Parkinson disease (PD), probably due to multifactorial pathogeneses including disease progression, dopaminergic drugs, or concomitant illness. In recent years, the pedunculopontine tegmental (PPTg) nucleus has been considered a surgical target for deep brain stimulation (DBS) in advanced PDpatients. As it is involved in controlling the sleep-wake cycle, we investigated the long-lasting effects of PPTg-DBS on the sleep of five PDpatients implanted in both the PPTg and the subthalamic nucleus (STN) by rating two subjective clinical scales for sleep: the Parkinson's Disease Sleep Scale (PDSS), and the Epworth Sleepiness Scale (ESS). STUDY DESIGN: Sleep scales were administered a week before surgery (T0), three months after DBS (T1), and one year later (T2). In this study, STN-DBS was kept constantly in ON, and three different patterns of PPTg-DBS were investigated: STN-ON (PPTg switched off); PPTg-ON (PPTg stimulated 24 h/day); PPTg-cycle (PPTg stimulated only at night). RESULTS: In post-surgery follow-up, PDpatients reported a marked improvement of sleep quality in all DBS conditions. In particular, stimulation of the PPTg nucleus produced not only a remarkable long-term improvement of nighttime sleep, but unlike STN-DBS, also produced significant amelioration of daytime sleepiness. CONCLUSION: Our study suggests that PPTg-DBS plays an important role in reorganizing regular sleep in PDpatients.
Authors: Jill L Ostrem; Chadwick W Christine; Graham A Glass; Lauren E Schrock; Philip A Starr Journal: Stereotact Funct Neurosurg Date: 2009-12-24 Impact factor: 1.875
Authors: Alexandros G Androulidakis; Paolo Mazzone; Vladimir Litvak; Will Penny; Michele Dileone; Louise M F Doyle Gaynor; Stephen Tisch; Vincenzo Di Lazzaro; Peter Brown Journal: Exp Neurol Date: 2008-01-19 Impact factor: 5.330
Authors: C Monaca; C Ozsancak; J M Jacquesson; I Poirot; S Blond; A Destee; J D Guieu; P Derambure Journal: J Neurol Date: 2004-02 Impact factor: 4.849