The effect of pallidal stimulation on sleep outcomes and related brain connectometries in Parkinson’s disease

IF 6.7 1区医学 Q1 NEUROSCIENCES

NPJ Parkinson's Disease Pub Date : 2024-11-04 DOI:10.1038/s41531-024-00800-4

Zhaoting Zheng, Defeng Liu, Houyou Fan, Hutao Xie, Quan Zhang, Guofan Qin, Yin Jiang, Fangang Meng, Zixiao Yin, Anchao Yang, Jianguo Zhang

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Abstract

Sleep difficulties affect up to 98% of Parkinson’s disease (PD) patients and are often not well treated. How globus pallidus internus (GPi)-DBS could help is less understood. We retrospectively analyzed sleep outcomes in 32 PD patients after GPi-DBS with a two-year follow-up. We observed high heterogeneity in sleep response to pallidal stimulation: 16 patients showed clinically meaningful improvement, 9 had minor changes, and 7 experienced worsened sleep quality, with no overall significant change on the Parkinson’s Disease Sleep Scale-2 (P = 0.19). Further analysis revealed that stimulation of the left sensorimotor GPi was significantly associated with sleep improvement. Fiber tracts from the left sensorimotor GPi to the bilateral sensorimotor cortex, right GPi, brainstem, and bilateral cerebellum were linked to better sleep, while projections to the left hippocampus correlated with worsened sleep. These findings may guide personalized GPi-DBS lead placement to optimize sleep outcomes in PD.

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刺激苍白球对帕金森病患者睡眠结果及相关脑连接测量的影响

多达98%的帕金森病（PD）患者会受到睡眠障碍的影响，而这些患者往往得不到很好的治疗。人们对苍白球内肌（GPi）-DBS如何发挥作用还不甚了解。我们对 32 名帕金森病患者进行了为期两年的 GPi-DBS 治疗后的睡眠状况进行了回顾性分析。我们观察到苍白球刺激后睡眠反应的高度异质性：16 名患者的睡眠质量得到了有临床意义的改善，9 名患者的睡眠质量略有变化，7 名患者的睡眠质量恶化，但帕金森病睡眠量表-2 的总体变化不大（P = 0.19）。进一步分析表明，刺激左侧感觉运动 GPi 与睡眠改善显著相关。从左侧感觉运动 GPi 到双侧感觉运动皮层、右侧 GPi、脑干和双侧小脑的纤维束与睡眠改善有关，而到左侧海马的投射与睡眠恶化有关。这些发现可指导个性化的 GPi-DBS 导联放置，以优化帕金森病患者的睡眠效果。

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来源期刊

NPJ Parkinson's Disease Medicine-Neurology (clinical)

CiteScore

9.80

自引率

5.70%

发文量

156

审稿时长

11 weeks

期刊介绍： npj Parkinson's Disease is a comprehensive open access journal that covers a wide range of research areas related to Parkinson's disease. It publishes original studies in basic science, translational research, and clinical investigations. The journal is dedicated to advancing our understanding of Parkinson's disease by exploring various aspects such as anatomy, etiology, genetics, cellular and molecular physiology, neurophysiology, epidemiology, and therapeutic development. By providing free and immediate access to the scientific and Parkinson's disease community, npj Parkinson's Disease promotes collaboration and knowledge sharing among researchers and healthcare professionals.