Effects of bilateral subthalamic stimulation on sleep in Parkinson's disease.
OBJECTIVE
Sleep disturbances are frequently observed in Parkinson's disease (PD). Bilateral chronic subthalamic nucleus (STN) stimulation is an alternative treatment for advanced PD. Improvements in motor disturbances after STN stimulation are well documented and seem to be associated with better sleep quality, even though the objective effect on sleep structure remains unclear. We have therefore studied the sleep/wakefulness cycle before and after surgical treatment in 10 consecutive parkinsonian patients.


METHODS
Subjective sleep quality and sleep recordings were evaluated one month before and three months after initiation of STN stimulation. After surgery, the recordings were performed under two conditions: with stimulation (the "on" condition) and-if patients had given their consent-in the absence of stimulation (the "off" condition).


RESULTS
With STN stimulation, subjective and objective sleep qualities were improved. Total sleep time, sleep efficiency and the durations of deep slow wave sleep and paradoxical sleep increased significantly. When stimulation was absent, sleep disturbances were similar to those observed before surgery.


CONCLUSIONS
Chronic STN stimulation is associated with a sleep improvement, which can be explained in part by the concomitant decrease in motor disturbances but also by the reduction in dosages of antiparkinsonian medication. However, we can not exclude a direct effect of STN stimulation on sleep regulatory centres.
Service de Neurophysiologie Clinique, EA2683 Hôpital R. Salengro, CHRU de Lille, Lille, France.
C
C
Monaca
C
C
Ozsancak
J M
JM
Jacquesson
I
I
Poirot
S
S
Blond
A
A
Destee
J D
JD
Guieu
P
P
Derambure
D000368:Aged; D003866:Depressive Disorder / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications* / Q000628:therapy*; D017286:Polysomnography; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012890:Sleep / Q000502:physiology; D012893:Sleep Wake Disorders / Q000209:etiology* / Q000628:therapy*; D012895:Sleep, REM / Q000502:physiology; D020531:Subthalamic Nucleus / Q000503:physiopathology* / Q000601:surgery; D016896:Treatment Outcome; D014851:Wakefulness / Q000502:physiology
D011619:Psychotropic Drugs