title: Subthalamic deep brain stimulation modulates conscious perception of sensory function in Parkinson's disease.
abstract: Subthalamic deep brain stimulation (STN-DBS) is used to treat refractory motor complications in Parkinson disease (PD), but its effects on nonmotor symptoms remain uncertain. Up to 80% of patients with PD may have pain relief after STN-DBS, but it is unknown whether its analgesic properties are related to potential effects on sensory thresholds or secondary to motor improvement. We have previously reported significant and long-lasting pain relief after DBS, which did not correlate with motor symptomatic control. Here we present secondary data exploring the effects of DBS on sensory thresholds in a controlled way and have explored the relationship between these changes and clinical pain and motor improvement after surgery. Thirty-seven patients were prospectively evaluated before STN-DBS and 12 months after the procedure compared with healthy controls. Compared with baseline, patients with PD showed lower thermal and mechanical detection and higher cold pain thresholds after surgery. There were no changes in heat and mechanical pain thresholds. Compared with baseline values in healthy controls, patients with PD had higher thermal and mechanical detection thresholds, which decreased after surgery toward normalization. These sensory changes had no correlation with motor or clinical pain improvement after surgery. These data confirm the existence of sensory abnormalities in PD and suggest that STN-DBS mainly influenced the detection thresholds rather than painful sensations. However, these changes may depend on the specific effects of DBS on somatosensory loops with no correlation to motor or clinical pain improvement.
authors: Pain Center, Department of Neurology, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil.|Movement Disorders Group, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil.
authors: Rubens G
authors: RG
authors: Cury
authors: Pain Center, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil.|Transcranial Magnetic Stimulation Laboratory, Psychiatry Institute, University of São Paulo, São Paulo, Brazil.
authors: Ricardo
authors: R
authors: Galhardoni
authors: Pain Center, Department of Neurology, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil.|Pain Center, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil.|Transcranial Magnetic Stimulation Laboratory, Psychiatry Institute, University of São Paulo, São Paulo, Brazil.|Neurosurgery Division, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil.
authors: Manoel J
authors: MJ
authors: Teixeira
authors: Neurosurgery Division, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil.
authors: Maria G
authors: MG
authors: Dos Santos Ghilardi
authors: Transcranial Magnetic Stimulation Laboratory, Psychiatry Institute, University of São Paulo, São Paulo, Brazil.
authors: Valquiria
authors: V
authors: Silva
authors: Transcranial Magnetic Stimulation Laboratory, Psychiatry Institute, University of São Paulo, São Paulo, Brazil.
authors: Martin L
authors: ML
authors: Myczkowski
authors: Transcranial Magnetic Stimulation Laboratory, Psychiatry Institute, University of São Paulo, São Paulo, Brazil.
authors: Marco A
authors: MA
authors: Marcolin
authors: Movement Disorders Group, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil.
authors: Egberto R
authors: ER
authors: Barbosa
authors: Pain Center, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil.|Neurosurgery Division, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil.
authors: Erich T
authors: ET
authors: Fonoff
authors: Pain Center, Department of Neurology, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil.|Pain Center, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil.|Transcranial Magnetic Stimulation Laboratory, Psychiatry Institute, University of São Paulo, São Paulo, Brazil.
authors: Daniel
authors: D
authors: Ciampi de Andrade
mesh_terms: D000328:Adult; D000368:Aged; D003244:Consciousness Disorders / Q000209:etiology* / Q000628:therapy; D046690:Deep Brain Stimulation / Q000379:methods*; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology; D017063:Outcome Assessment, Health Care; D010146:Pain / Q000209:etiology*; D059408:Pain Management; D010300:Parkinson Disease / Q000150:complications* / Q000523:psychology / Q000628:therapy*; D010812:Physical Stimulation; D011788:Quality of Life; D012684:Sensory Thresholds / Q000502:physiology*; D018709:Statistics, Nonparametric; D020530:Subthalamus / Q000502:physiology*