title: Comparison of frequencies of non motor symptoms in Indian Parkinson's disease patients on medical management versus deep brain stimulation: A case-control study.
abstract: BACKGROUND
  Non motor symptoms (NMS) of idiopathic Parkinson's disease (PD) are a major cause of disability and recognition of these symptoms and treatment is important for comprehensive health care. Deep brain stimulation of bilateral subthalamic nucleus deep brain stimulation (STN DBS) has been shown to improve motor symptoms in PD and effects on NMS are unknown. To investigate the NMS among PD patients who underwent STN DBS.
  
  
  METHODS
  We recruited prospectively 56 patients with PD, who had undergone bilateral STN DBS and 53 age and duration of illness matched PD patients on dopaminergic therapy (controls). NMS were assessed using 30 item questionnaire NMS Quest. These questions evaluated 9 domains, gastrointestinal, urinary, cardiovascular, sexual, cognition (apathy/attention/memory), anxiety/depression, hallucinations/delusions, sleep and miscellaneous. Comparison was done on individual symptoms as well as in various domains. This study was carried at Nizam's Institution of Medical Sciences and study period was from January 2011 to December 2012.
  
  
  RESULTS
  Patients who underwent STN DBS had a significantly lower mean total score on NMS quest (6.7 ± 3.8) compared to controls (8.4 ± 3.7) (P < 0.00100). Symptoms in the domains of cardiovascular, gastrointestinal, sleep were significantly less frequent while sexual disturbances were significantly more frequent among patients compared to controls. On individual symptom analysis, nocturia  (P < 0.00010), unexplained pains (P < 0.00010), nausea and vomiting, constipation, lightheadedness, depression, and insomnia were less prevalent, while sexual disturbances were significantly more common in STN DBS group compared to controls.
  
  
  CONCLUSIONS
  Bilateral STN DBS not only improves the motor symptoms but also improves many NMS in PD patients.
authors.affiliation: Department of Neurology, Nizam's Institute of Medical Sciences, Autonomous University, Hyderabad, India.
authors.forename: Kandadai
authors.initials: K
authors.lastname: Rukmini Mridula
authors.affiliation: Department of Neurology, Nizam's Institute of Medical Sciences, Autonomous University, Hyderabad, India.
authors.forename: Rupam
authors.initials: R
authors.lastname: Borgohain
authors.affiliation: Department of Neurology, Nizam's Institute of Medical Sciences, Autonomous University, Hyderabad, India.
authors.forename: Shaik Afshan
authors.initials: SA
authors.lastname: Jabeen
authors.affiliation: Department of Neurology, Nizam's Institute of Medical Sciences, Autonomous University, Hyderabad, India.
authors.forename: Gaddamanugu
authors.initials: G
authors.lastname: Padmaja
authors.affiliation: Department of Research, Yashoda Hospital Somajiguda Hyderabad, India.
authors.forename: Vcs Srinivasarao
authors.initials: VS
authors.lastname: Bandaru
authors.affiliation: Department of Neurosurgery, Nizam's Institute of Medical Sciences, Autonomous University, Hyderabad, India.
authors.forename: Praveen
authors.initials: P
authors.lastname: Ankathi
authors.affiliation: Department of Neurology, Nizam's Institute of Medical Sciences, Autonomous University, Hyderabad, India.
authors.forename: Meena A
authors.initials: MA
authors.lastname: Kanikannan
authors.affiliation: Department of Neurology, Nizam's Institute of Medical Sciences, Autonomous University, Hyderabad, India.
authors.forename: Mohammed Shujath
authors.initials: MS
authors.lastname: Ali Khan
keywords: Comprehensive Health Care; Deep Brain Stimulation; Dopamine Agents; Parkinson Disease; Subthalamic Nucleus