Session Information
Date: Wednesday, September 25, 2019
Session Title: Non-Motor Symptoms
Session Time: 1:15pm-2:45pm
Location: Agora 3 West, Level 3
Objective: Objectives: To evaluate the impact of acute STN-DBS on the autonomic nervous system through clinical validated scales (SCOPA-AUT and PDSS).
Background: Background: Several studies point to a hypothalamic dysfunction as an important cause to autonomic symptoms in Parkinson Disease (PD). The deep brain stimulation of subthalamic nucleus (STN-DBS) is an important therapy to motor symptoms and it cans modulate pathways and neighbor structures. The hypothalamus (HTH) and STN are contiguous structures with imprecise borders and given its anatomical proximity, the HTH could be affected by the STN stimulation.
Method: Methods: Longitudinal observational case-series study composed of subjects with PD patient who underwent STN-DBS due to motor complications. The clinical evaluation was performed before and 3 months after surgery. The autonomic function was evaluated with the SCOPA-AUT questionnaire which consists in six parts: gastrointestinal, urinary, cardiovascular, termoregulatory, pupilomotor and sexual function. To evaluate the circadian cycle (sleep) it was used the Parkinson Disease Sleep Scale (PDSS). A complementary evaluation of heart rate variability with holter was also performed. The level of significance was set at 5% (p<0.05).
Results: Results: The sample was composed for 9 men and 1 women with mean age of 57 years (SD 14.2). The mean in UPDRS improvement was 66% (SD 12%). There was a significantly improvement in SCOPA AUT index (p<0.001) due to improvement on gastrointestinal (p<0.001) and urinary function (p<0.03). PDSS show an important improvement in the sleep quality (p<0.01). Five patients were evaluated with holter pre- and post-DBS and there was a tendency to increase basal heart rate (p = 0.057)
Conclusion: Conclusion: STN-DBS in the acute phase has a positive impact in the sleep quality, gastrointestinal and urinary function and a tendency to affect basal heart rate. Further studies are need in order to evaluate whether these findings are related to a direct modulation of STN-DBS in hypothalamic activity.
To cite this abstract in AMA style:
D. Dos Santos, E. Barbosa, R. Cury. Deep Brain Stimulation of Subthalamic Nucleus (DBS-STN) in Parkinson Disease (PD): Acute Clinical Effects in Hypothalamic control [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/deep-brain-stimulation-of-subthalamic-nucleus-dbs-stn-in-parkinson-disease-pd-acute-clinical-effects-in-hypothalamic-control/. Accessed November 21, 2024.« Back to 2019 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/deep-brain-stimulation-of-subthalamic-nucleus-dbs-stn-in-parkinson-disease-pd-acute-clinical-effects-in-hypothalamic-control/