Division of Movement Disorders, Department of Neurology, University of Alabama at Birmingham, SC 360, 1530 3rd Avenue South, Birmingham, AL 35294-0017, USA.
Ther Adv Neurol Disord. 2011 Jan;4(1):15-24. doi: 10.1177/1756285610392446.
Sleep dysfunction is a common nonmotor symptom experienced by patients with Parkinson's disease (PD). Symptoms, including excessive daytime sleepiness, sleep fragmentation, rapid eye movement (REM) sleep behavior disorder and others, can significantly affect quality of life and daytime functioning in these patients. Recent studies have evaluated the effects of deep brain stimulation (DBS) at various targets on sleep in patients with advanced PD. Several of these studies have provided evidence that subthalamic nucleus DBS improves subjective and objective measures of sleep, including sleep efficiency, nocturnal mobility, and wake after sleep onset (minutes spent awake after initial sleep onset). Although fewer studies have investigated the effects of bilateral internal globus pallidus and thalamic ventral intermedius DBS on sleep, pallidal stimulation does appear to improve subjective sleep quality. Stimulation of the pedunculopontine nucleus has recently been proposed for selected patients with advanced PD to treat severe gait and postural dysfunction. Owing to the role of the pedunculopontine nucleus in modulating behavioral state, the impact of stimulation at this target on sleep has also been evaluated in a small number of patients, showing that pedunculopontine nucleus DBS increases REM sleep. In this review, we discuss the effects of stimulation at these various targets on sleep in patients with PD. Studying the effects of DBS on sleep can enhance our understanding of the pathophysiology of sleep disorders, provide strategies for optimizing clinical benefit from DBS, and may eventually guide novel therapies for sleep dysfunction.
睡眠障碍是帕金森病（PD）患者常见的非运动症状。这些症状，包括白天过度嗜睡、睡眠碎片化、快速眼动（REM）睡眠行为障碍等，会显著影响这些患者的生活质量和白天的功能。最近的研究评估了深部脑刺激（DBS）在不同靶点对晚期 PD 患者睡眠的影响。其中一些研究提供了证据，表明丘脑底核 DBS 可改善睡眠的主观和客观测量指标，包括睡眠效率、夜间活动度和睡眠起始后觉醒（初始睡眠起始后醒着的分钟数）。尽管较少的研究调查了双侧苍白球内和丘脑腹侧中间核 DBS 对睡眠的影响，但苍白球刺激似乎确实改善了主观睡眠质量。由于动眼神经核在调节行为状态方面的作用，刺激该靶点对睡眠的影响也在少数患者中进行了评估，结果表明，动眼神经核 DBS 可增加 REM 睡眠。在这篇综述中，我们讨论了这些不同靶点的刺激对 PD 患者睡眠的影响。研究 DBS 对睡眠的影响可以增强我们对睡眠障碍病理生理学的理解，为从 DBS 中获得最佳临床效益提供策略，最终可能为睡眠障碍的新型治疗方法提供指导。
