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Sleep symptoms and polysomnographic architecture in advanced Parkinson's disease after chronic bilateral subthalamic stimulation
  1. A Iranzo1,
  2. F Valldeoriola1,
  3. J Santamaría1,
  4. E Tolosa1,
  5. J Rumià2
  1. 1Service of Neurology, Hospital Clinic i Provincial de Barcelona, Barcelona, Spain
  2. 2Service of Neurosurgery, Hospital Clinic i Provincial de Barcelona
  1. Correspondence to:
 Dr Alex Iranzo, Neurology Service, Hospital Clinic de Barcelona, C/Villarroel 170, Barcelona 08036, Spain;
 airanzo{at}clinic.ub.es

Abstract

Objective: To evaluate the sleep symptoms and polysomnographic architecture in advanced Parkinson's disease after chronic bilateral subthalamic stimulation (STN-DBS).

Methods: Sleep was studied in 11 patients (six women and five men; mean (SD) age 63.6 (7.8) years) who underwent STN-DBS. Subjective sleep evaluation was assessed by clinical sleep interview and the Pittsburgh sleep quality index (PSQI) questionnaire, and sleep architecture by polysomnography with audiovisual recording. Nocturnal mobility was evaluated.

Results: Before surgery, eight patients rated their sleep quality as unsatisfactory; seven of these had a marked improvement after surgery, and the PSQI questionnaire showed significantly improved sleep quality. After surgery, polysomnography showed an increase in the longest period of uninterrupted sleep and a decrease in the arousal index. There was an increase in nocturnal mobility after surgery, but no change in REM sleep behaviour disorder.

Conclusions: In advanced Parkinson's disease, chronic STN-DBS is associated with subjective improvement in sleep quality, probably through increased nocturnal mobility and reduction of sleep fragmentation.

  • Parkinson's disease
  • sleep symptoms
  • polysomnography
  • subthalamic stimulation
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