title: Bilateral Subthalamic Stimulation can Improve Sleep Quality in Parkinson's Disease.
abstract: BACKGROUND
  Sleep problems are among the most common non-motor symptoms of Parkinson's disease (PD). The PD Sleep Scale 2nd version (PDSS-2) improved the original PDSS by adding more items on different aspects of sleep problems, making it a more robust tool to evaluate the severity of sleep disturbances. However, previous studies on deep brain stimulation (DBS) have not used the PDSS-2.
  
  
  OBJECTIVE
  To determine if the PDSS-2 could detect improvement reliably in sleep problems after bilateral subthalamic nucleus DBS for PD.
  
  
  METHODS
  In this prospective study, 25 consecutive patients undergoing DBS implantation were enrolled. Patients were examined twice: 1 week prior to the DBS implantation (baseline) and 12 months postoperatively. Severity of PD symptoms were assessed by the Movement Disorders Society Unified PD Rating Scale (MDS-UPDRS) and the Non-Motor Symptoms Scale (NMSS). Presence and severity of sleep disturbances were specifically measured by PDSS-2.
  
  
  RESULTS
  Total score of MDS-UPDRS improved from 81 (median, interquartile-range: 63-103) to 55 points (median, IQR: 46-75, p <  0.001). Health-related quality of life, measured by PDQ-39, also improved from 29 (IQR: 18-40) to 15 (IQR: 9-28) points (p = 0.002). Most domains of NMSS also improved. At baseline 13 patients reported sleep problems, but 1 year after DBS implantation only 3 did (p = 0.012). Although only 6 out of 15 items showed a significant decrease after DBS implantation, the total score of PDSS-2 decreased from 24 (IQR: 17-32) to 10 (IQR: 7-18) points (P <  0.001).
  
  
  CONCLUSIONS
  Based on our results, PDSS-2 can detect improvements in sleep quality reliably after DBS implantation.
authors.affiliation: Doctoral School of Clinical Neuroscience, University of Pécs, Pécs, Hungary.|Department of Neurology, University of Pécs, Pécs, Hungary.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Deli
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary.
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Aschermann
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary.
authors.forename: Péter
authors.initials: P
authors.lastname: Ács
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary.
authors.forename: Edit
authors.initials: E
authors.lastname: Bosnyák
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary.|MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary.
authors.forename: József
authors.initials: J
authors.lastname: Janszky
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary.
authors.forename: Béla
authors.initials: B
authors.lastname: Faludi
authors.affiliation: Doctoral School of Clinical Neuroscience, University of Pécs, Pécs, Hungary.
authors.forename: Attila
authors.initials: A
authors.lastname: Makkos
authors.affiliation: Doctoral School of Clinical Neuroscience, University of Pécs, Pécs, Hungary.
authors.forename: Márton
authors.initials: M
authors.lastname: Kovács
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary.
authors.forename: Sámuel
authors.initials: S
authors.lastname: Komoly
authors.affiliation: Department of Neurosurgery, University of Pécs, Pécs, Hungary.
authors.forename: István
authors.initials: I
authors.lastname: Balás
authors.affiliation: MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary.|Department of Neurosurgery, University of Pécs, Pécs, Hungary.
authors.forename: Tamás
authors.initials: T
authors.lastname: Dóczi
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary.|MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary.
authors.forename: Norbert
authors.initials: N
authors.lastname: Kovács
mesh_terms: D046690:Deep Brain Stimulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications*; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000209:etiology / Q000517:prevention & control*; D020531:Subthalamic Nucleus / Q000503:physiopathology*
keywords: Sleep; non-motor symptoms; restless legs syndrome; subthalamic deep brain stimulation