January 2012
Amara AW, Standaert DG, Guthrie S, Cutter G,
Watts RL, Walker H
Background: Sleep disturbances are common in Parkinson’s
disease (PD). Bilateral subthalamic nucleus (STN) deep brain stimulation
(DBS) is superior to best medical therapy in the treatment of motor
symptoms in advanced PD, and observational studies suggest that
bilateral STN DBS improves sleep in these patients as well. Unilateral
STN DBS also improves motor function in PD, but its effects on sleep
have not been extensively investigated.
Methods: We report
the effects of unilateral STN DBS on subjective sleep quality as
measured by the Pittsburgh Sleep Quality Index (PSQI) in 53 consecutive
PD patients. These subjects completed the PSQI prior to surgery and at 3
and 6 months post-operatively. The primary outcome measure was the
change in the global PSQI at 6 months post-operatively versus the
pre-operative baseline, measured with repeated measures analysis of
variance (ANOVA).
Results: Patients with PD who underwent
unilateral STN DBS had a significant improvement in PSQI at 6 months
post-operatively (baseline 9.30 ± 0.56 (mean ± SEM), 6 months:
7.93 ± 0.56, p = 0.013). Supplemental analyses showed that
subjects selected for STN DBS placed on the right had worse baseline
subjective sleep quality and more improvement in PSQI at 6 months
compared to patients who received left STN DBS.
Conclusion: This
prospective case series study provides evidence that unilateral STN DBS
improves subjective sleep quality in patients with PD at up to 6 months
post-operatively as measured by the PSQI.
