Abstract
Introduction The aim of this meta-analysis was to evaluate the effects of STN DBS on sleep quality and restless leg symptoms in individuals with PD. Methods We searched the PubMed, Web of Science, EMBASE, CNKI, and WANFANG databases published between 1990 and 2019. The articles included were those that contained both pre- and postsurgery data acquired using International RLS Study Group criteria and the Pittsburgh sleep quality index (PSQI) questionnaire with patients' follow-up of at least three months. All studies that met the quality requirements were included in a meta-analysis performed using STATA 12.0 software. Results Of 73 articles identified, 7 studies comprising 82 patients were qualified for the current meta-analysis. After adjusting for heterogeneity in study effect sizes, the random effects meta-analysis indicated that STN DBS improved sleep quality and restless leg symptoms significantly (SMD = −1.111, 95% CI: −1.918∼−0.304, P=0.007). Subgroup analysis showed that different sleep scoring criteria had different effects on the condition of sleeping after surgery. Conclusions STN DBS is a powerful method in the management of sleep quality and restless leg symptoms in PD patients, but its long-term effects with larger populations must be thoroughly assessed.
Highlights
Parkinson’s disease (PD), as a primary reason of morbidity and mortality worldwide, is a debilitating neurodegenerative condition characterized by motor and nonmotor symptoms among middle-aged and elderly individuals
STN deep brain stimulation (DBS) significantly improves patients’ primary motor symptoms as well as the quality of life, reducing their need for medications [5, 6]. e influence of STN DBS on nonmotor symptoms (NMS) of PD has received only a smaller amount of attention, even though recent records indicate that NMS occur in up to 100% of PD patients [7]
Numerous studies have documented that the majority of patients who undergo STN DBS achieve amelioration of motor symptoms and quality of life
Summary
Parkinson’s disease (PD), as a primary reason of morbidity and mortality worldwide, is a debilitating neurodegenerative condition characterized by motor and nonmotor symptoms among middle-aged and elderly individuals. As for treatment methods, currently, antiparkinsonian medication and surgical interventions have become mainstream [1, 2]. Antiparkinsonian drugs, which are currently the first-line therapy for PD, are mostly used in patients during the early stage of the disease [3]. Surgery using deep brain stimulation (DBS) is done during midstage to late-stage of the disease in patients with decreased sensitivity to available medicines or in patients with druginduced complications [4]. Deep brain stimulation, which involves the application of electrical stimuli in specific nuclei, was clinically used in the late 1990s for the treatment of PD, and this technique has been widely and increasingly accepted during last 20 years. STN DBS significantly improves patients’ primary motor symptoms as well as the quality of life, reducing their need for medications [5, 6]. It is imperative to frequently evaluate the development or deterioration of nonmotor symptoms in DBS patients
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