Effects of bilateral subthalamic stimulation on sleep in Parkinson's disease
Effects of bilateral subthalamic stimulation on sleep in Parkinson's disease
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DOI：
10.1007/s00415-004-0305-7
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发表时间：
2004-02-01
影响因子：
6
通讯作者：
Derambure, P
中科院分区：
文献类型：
--
作者：
Monaca, C;Ozsancak, C;Derambure, P
目的 睡眠障碍在帕金森病 (PD) 中很常见。双侧慢性丘脑底核 (STN) 刺激是晚期 PD 的替代治疗方法。 STN 刺激后运动障碍的改善已有充分记录，并且似乎与更好的睡眠质量相关，尽管对睡眠结构的客观影响仍不清楚。因此，我们连续研究了 10 名帕金森病患者手术治疗前后的睡眠/觉醒周期。方法在开始 STN 刺激前 1 个月和后 3 个月评估主观睡眠质量和睡眠记录。手术后，在两种条件下进行记录：有刺激（“开启”条件）和 - 如果患者同意 - 无刺激（“关闭”条件）。结果通过STN刺激，主观和客观睡眠质量均得到改善。总睡眠时间、睡眠效率以及深度慢波睡眠和反常睡眠的持续时间显着增加。当没有刺激时，睡眠障碍与手术前观察到的相似。结论 慢性 STN 刺激与睡眠改善相关，部分原因是伴随的运动障碍减少，但也可以通过抗帕金森病药物剂量的减少来解释。然而，我们不能排除 STN 刺激对睡眠调节中心的直接影响。
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. Conclusion 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.