scholarly journals Parkinson patients have a presynaptic serotonergic deficit: A dynamic deep brain stimulation PET study

2021 ◽  
pp. 0271678X2098238
Author(s):  
Louise M Jørgensen ◽  
Tove Henriksen ◽  
Skirmante Mardosiene ◽  
Sune H Keller ◽  
Dea S Stenbæk ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Brain Regions ◽  
Significant Loss ◽  
Serotonergic System ◽  
Motor Symptom ◽  
Motor Symptoms ◽  
Serotonin System ◽  
Non Motor Symptoms ◽  
Deep Brain

Patients with Parkinson’s disease (PD) often suffer from non-motor symptoms, which may be caused by serotonergic dysfunction. Apart from alleviating the motor symptoms, Deep Brain Stimulation (DBS) in the subthalamic nucleus (STN) may also influence non-motor symptoms. The aim of this study is to investigate how turning DBS off affects the serotonergic system. We here exploit a novel functional PET neuroimaging methodology to evaluate the preservation of serotonergic neurons and capacity to release serotonin. We measured cerebral 5-HT1BR binding in 13 DBS-STN treated PD patients, at baseline and after turning DBS off. Ten age-matched volunteers served as controls. Clinical measures of motor symptoms were assessed under the two conditions and correlated to the PET measures of the static and dynamic integrity of the serotonergic system. PD patients exhibited a significant loss of frontal and parietal 5-HT1BR, and the loss was significantly correlated to motor symptom severity. We saw a corresponding release of serotonin, but only in brain regions with preserved 5-HT1BR, suggesting the presence of a presynaptic serotonergic deficit. Our study demonstrates that DBS-STN dynamically regulates the serotonin system in PD, and that preservation of serotonergic functions may be predictive of DBS-STN effects.

Effects of deep brain stimulation on sleep-wake disturbances in patients with Parkinson's disease: A narrative review

2021 ◽  
Vol 19 ◽  
Author(s):  
Yu Jin Jung ◽  
Han-Joon Kim ◽  
Sun Ha Paek ◽  
Beomseok Jeon
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Early Stage ◽  
Motor Symptoms ◽  
Specific Effects ◽  
The Impact ◽  
Non Motor Symptoms ◽  
Deep Brain

: Sleep-wake disturbances (SWD) are one of the most common non-motor symptoms in Parkinson's disease (PD) and can appear in the early stage even before the onset of motor symptoms. Deep brain stimulation (DBS) is an established treatment for the motor symptoms in patients with advanced PD. However, the effect of DBS on SWD and its specific mechanisms are not widely understood and remain controversial. In addition to the circuit-mediated direct effect, DBS may improve SWD by an indirect effect such as the resolution of nocturnal motor complications and a reduction of dopaminergic medication. Here, the authors review the recent literatures regarding the impact of DBS on SWD in patients with PD. Furthermore, the selection of the DBS targets and the specific effects of applying DBS to each target on SWD in PD are also discussed.

An Update of the Impact of Deep Brain Stimulation on Non Motor Symptoms in Parkinson's Disease

2014 ◽  
Vol 4 (2) ◽  
pp. 289-300 ◽  
Author(s):  
Lisa Klingelhoefer ◽  
Michael Samuel ◽  
K. Ray Chaudhuri ◽  
Keyoumars Ashkan
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Motor Symptoms ◽  
The Impact ◽  
Non Motor Symptoms ◽  
Deep Brain

scholarly journals Deep Brain Stimulation Selection Criteria for Parkinson’s Disease: Time to Go beyond CAPSIT-PD

2020 ◽  
Vol 9 (12) ◽  
pp. 3931
Author(s):  
Carlo Alberto Artusi ◽  
Leonardo Lopiano ◽  
Francesca Morgante
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Selection Criteria ◽  
Challenge Test ◽  
Phenotypic Characterization ◽  
Motor Symptoms ◽  
Non Motor Symptoms ◽  
Deep Brain

Despite being introduced in clinical practice more than 20 years ago, selection criteria for deep brain stimulation (DBS) in Parkinson’s disease (PD) rely on a document published in 1999 called ‘Core Assessment Program for Surgical Interventional Therapies in Parkinson’s Disease’. These criteria are useful in supporting the selection of candidates. However, they are both restrictive and out-of-date, because the knowledge on PD progression and phenotyping has massively evolved. Advances in understanding the heterogeneity of PD presentation, courses, phenotypes, and genotypes, render a better identification of good DBS outcome predictors a research priority. Additionally, DBS invasiveness, cost, and the possibility of serious adverse events make it mandatory to predict as accurately as possible the clinical outcome when informing the patients about their suitability for surgery. In this viewpoint, we analyzed the pre-surgical assessment according to the following topics: early versus delayed DBS; the evolution of the levodopa challenge test; and the relevance of axial symptoms; patient-centered outcome measures; non-motor symptoms; and genetics. Based on the literature, we encourage rethinking of the selection process for DBS in PD, which should move toward a broad clinical and instrumental assessment of non-motor symptoms, quantitative measurement of gait, posture, and balance, and in-depth genotypic and phenotypic characterization.

The impact of subthalamic deep brain stimulation on sleep and other non-motor symptoms in Parkinson's disease

2019 ◽  
Vol 64 ◽  
pp. 138-144 ◽  
Author(s):  
Jarosław Dulski ◽  
Michał Schinwelski ◽  
Agnieszka Konkel ◽  
Karol Grabowski ◽  
Witold Libionka ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Motor Symptoms ◽  
The Impact ◽  
Non Motor Symptoms ◽  
Deep Brain

Acute response of non-motor symptoms to subthalamic deep brain stimulation in Parkinson's disease

2017 ◽  
Vol 41 ◽  
pp. 113-117 ◽  
Author(s):  
Margherita Fabbri ◽  
Miguel Coelho ◽  
Leonor Correia Guedes ◽  
Mario M. Rosa ◽  
Daisy Abreu ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Motor Symptoms ◽  
Acute Response ◽  
Non Motor Symptoms ◽  
Deep Brain

scholarly journals Effect of Deep Brain Stimulation on Parkinson's Nonmotor Symptoms following Unilateral DBS: A Pilot Study

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Nelson Hwynn ◽  
Ihtsham Ul Haq ◽  
Irene A. Malaty ◽  
Andrew S. Resnick ◽  
Yunfeng Dai ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Pilot Study ◽  
Brain Stimulation ◽  
Surgical Patients ◽  
Motor Symptoms ◽  
Nonmotor Symptoms ◽  
Future Studies ◽  
Non Motor Symptoms ◽  
Deep Brain

Parkinson’s disease (PD) management has traditionally focused largely on motor symptoms. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) and globus pallidus internus (GPi) are effective treatments for motor symptoms. Nonmotor symptoms (NMSs) may also profoundly affect the quality of life. The purpose of this pilot study was to evaluate NMS changes pre- and post-DBS utilizing two recently developed questionnaires.Methods. NMS-Q (questionnaire) and NMS-S (scale) were administered to PD patients before/after unilateral DBS (STN/GPi targets).Results. Ten PD patients (9 STN implants, 1 GPi implant) were included. The three most frequent NMS symptoms identified utilizing NMS-Q in pre-surgical patients were gastrointestinal (100%), sleep (100%), and urinary (90%). NMS sleep subscore significantly decreased (−1.6 points ± 1.8, ). The three most frequent NMS symptoms identified in pre-surgical patients using NMS-S were gastrointestinal (90%), mood (80%), and cardiovascular (80%). The largest mean decrease of NMS scores was seen in miscellaneous symptoms (pain, anosmia, weight change, and sweating) (−7 points ± 8.7), and cardiovascular/falls (−1.9, ).Conclusion. Non-motor symptoms improved on two separate questionnaires following unilateral DBS for PD. Future studies are needed to confirm these findings and determine their clinical significance as well as to examine the strengths/weaknesses of each questionnaire/scale.

scholarly journals Deep brain stimulation electrode position impact on parkinsonian non-motor symptoms

2020 ◽  
Author(s):  
Jan Bardon ◽  
Sandra Kurcova ◽  
Monika Chudackova ◽  
Pavel Otruba ◽  
David Krahulik ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Electrode Position ◽  
Motor Symptoms ◽  
Deep Brain Stimulation Electrode ◽  
Non Motor Symptoms ◽  
Stimulation Electrode ◽  
Deep Brain
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