TY - JOUR
T1 - Deep brain stimulation of pedunculopontine tegmental nucleus
T2 - Role in sleep modulation in advanced Parkinson disease patients - One-year follow-up
AU - Peppe, Antonella
AU - Pierantozzi, Mariangela
AU - Baiamonte, Valentina
AU - Moschella, Vincenzo
AU - Caltagirone, Carlo
AU - Stanzione, Paolo
AU - Stefani, Alessandro
PY - 2012/12/1
Y1 - 2012/12/1
N2 - Study Objective: Sleep disorders are frequent non-motor symptoms in Parkinson disease (PD), probably due to multifactorial pathogeneses including disease progression, dopaminergic drugs, or concomitant illness. In recent years, the pedunculopontine tegmental (PPTg) nucleus has been considered a surgical target for deep brain stimulation (DBS) in advanced PD patients. As it is involved in controlling the sleep-wake cycle, we investigated the long-lasting effects of PPTg-DBS on the sleep of five PD patients implanted in both the PPTg and the subthalamic nucleus (STN) by rating two subjective clinical scales for sleep: the Parkinson's Disease Sleep Scale (PDSS), and the Epworth Sleepiness Scale (ESS). Study Design: Sleep scales were administered a week before surgery (T0), three months after DBS (T1), and one year later (T2). In this study, STN-DBS was kept constantly in ON, and three different patterns of PPTg-DBS were investigated: STN-ON (PPTg switched off); PPTg-ON (PPTg stimulated 24 h/day); PPTg-cycle (PPTg stimulated only at night). Results: In post-surgery follow-up, PD patients reported a marked improvement of sleep quality in all DBS conditions. In particular, stimulation of the PPTg nucleus produced not only a remarkable long-term improvement of nighttime sleep, but unlike STN-DBS, also produced significant amelioration of daytime sleepiness. Conclusion: Our study suggests that PPTg-DBS plays an important role in reorganizing regular sleep in PD patients.
AB - Study Objective: Sleep disorders are frequent non-motor symptoms in Parkinson disease (PD), probably due to multifactorial pathogeneses including disease progression, dopaminergic drugs, or concomitant illness. In recent years, the pedunculopontine tegmental (PPTg) nucleus has been considered a surgical target for deep brain stimulation (DBS) in advanced PD patients. As it is involved in controlling the sleep-wake cycle, we investigated the long-lasting effects of PPTg-DBS on the sleep of five PD patients implanted in both the PPTg and the subthalamic nucleus (STN) by rating two subjective clinical scales for sleep: the Parkinson's Disease Sleep Scale (PDSS), and the Epworth Sleepiness Scale (ESS). Study Design: Sleep scales were administered a week before surgery (T0), three months after DBS (T1), and one year later (T2). In this study, STN-DBS was kept constantly in ON, and three different patterns of PPTg-DBS were investigated: STN-ON (PPTg switched off); PPTg-ON (PPTg stimulated 24 h/day); PPTg-cycle (PPTg stimulated only at night). Results: In post-surgery follow-up, PD patients reported a marked improvement of sleep quality in all DBS conditions. In particular, stimulation of the PPTg nucleus produced not only a remarkable long-term improvement of nighttime sleep, but unlike STN-DBS, also produced significant amelioration of daytime sleepiness. Conclusion: Our study suggests that PPTg-DBS plays an important role in reorganizing regular sleep in PD patients.
KW - Parkinson disease
KW - PPTg
KW - Sleep
KW - STN DBS
UR - http://www.scopus.com/inward/record.url?scp=84870522174&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84870522174&partnerID=8YFLogxK
U2 - 10.5665/sleep.2234
DO - 10.5665/sleep.2234
M3 - Article
C2 - 23204606
AN - SCOPUS:84870522174
VL - 35
SP - 1637
EP - 1642
JO - Sleep
JF - Sleep
SN - 0161-8105
IS - 12
ER -