Universität zu Köln

Kurtis, Mnica M., Rajah, Thadshani, Delgado, Luisa F. and Dafsari, Haidar S. (2017). The effect of deep brain stimulation on the non-motor symptoms of Parkinson's disease: a critical review of the current evidence. npj Parkinsons Dis., 2. LONDON: NATURE PUBLISHING GROUP. ISSN 2373-8057

Full text not available from this repository.

Abstract

The benefit of deep brain stimulation (DBS) in controlling the motor symptoms of Parkinson's disease is well established, however, the impact on the non-motor symptoms (NMS) remains to be elucidated, although the growing investigative efforts are promising. This article reviews the reported data and considers the level of evidence available with regard to the effect of DBS on NMS total burden and on the cognitive, neuropsychiatric, sleep, pain, dysautonomic, and weight domains. Multiple case series suggest that DBS improves the burden of NMS by reducing prevalence, intensity, and non-motor fluctuations. There is level I evidence on the effect of DBS on cognition and mood. Slight cognitive decline has been reported in most class I studies, although the functional effect is probably minimal. Two randomized prospective studies reported no change in depression while improvement of anxiety has been reported by a class I trial. Prospective cohort studies point to improvement of hyperdopaminergic behaviors, such as impulse control disorders, while others report that hypodopaminergic states, like apathy, can appear after DBS. There is only class III evidence supporting the benefit of DBS on other NMS such as nocturnal sleep, pain, dysautonomia (urinary, gastrointestinal, cardiovascular, and sweating), and weight loss. Although preliminary results are promising, randomized prospectively controlled trials with NMS as primary end points are necessary to further explore the effect of DBS on these often invalidating symptoms and offer conclusions about efficacy.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kurtis, Mnica M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Rajah, Thadshani UNSPECIFIED UNSPECIFIED UNSPECIFIED Delgado, Luisa F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Dafsari, Haidar S. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-242537
DOI:	10.1038/npjparkd.2016.24
Journal or Publication Title:	npj Parkinsons Dis.
Volume:	2
Date:	2017
Publisher:	NATURE PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	2373-8057
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BILATERAL SUBTHALAMIC STIMULATION; BODY-WEIGHT GAIN; BASAL GANGLIA; FOLLOW-UP; NUCLEUS STIMULATION; OLFACTORY FUNCTION; URINARY-BLADDER; MEDICAL THERAPY; IMPULSE CONTROL; SLEEP QUALITY Multiple languages Neurosciences Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/24253