Non-motor effects of subthalamic nucleus deep brain stimulation in parkinson's disease: experience in a series of 102 patients

Abstract

Objective This study evaluated the effects of relieving the non-motor symptoms (neuropsychiatry,sleep disorders,antonomic,gastrointestinal and sensory disorders) of STN DBS in patients with PD followed up for a half to six years. Method A consecutive series of 102 patients was assessed one week before and a haft to six years after surgery. The non-motor symptoms(NMS) questionnaire was used to assess the range of NMS and outcome after surgery. The NMS questionnaire comprised 23 items which were designed simply to be understood for patients. Besides, depression was evaluated using self-completed depression scale (SDS). Anxiety was evaluated using self-completed anxiety scale (SAS) system. All these scales were performed at every evaluation. Results Before surgery, on average, patients reported 7.1 NMS in average. There was a significant association of NMS score in PD patients with Hoehn-Yahr stage ( r =0.49, P<0.01). After surgery, NMS was still common in PD patients. However,six items of NMS (pain, paraesthesia, insomnia, vivid dreaming, restless legs, weight loss) were significantly less reported postoperationly by PD patients than pre-operation state(Pearson Chi-square test, P=0.00～0.02). While other problems of NMS,especially the score of depression and anxiety did not change. Conclusions NMS can be observed in all PD patients across all disease stages and correlates to the disease progression. STN DBS do not lead to comprehensive improvement of NMS in PD. However, STN DBS may contribute to the reducing of several items of NMS:pain ,paraesthesia, insomnia, vivid dreaming,restless legs and weight loss. Key words: Parkinson disease; Deep brain stimulation; Non-motor symptoms