Doctoral School of Clinical Neuroscience, University of Pécs, Pécs, Hungary.
Department of Neurology, University of Pécs, Pécs, Hungary.
J Parkinsons Dis. 2015;5(2):361-8. doi: 10.3233/JPD-150540.
Sleep problems are among the most common non-motor symptoms of Parkinson's disease (PD). The PD Sleep Scale 2nd version (PDSS-2) improved the original PDSS by adding more items on different aspects of sleep problems, making it a more robust tool to evaluate the severity of sleep disturbances. However, previous studies on deep brain stimulation (DBS) have not used the PDSS-2.
To determine if the PDSS-2 could detect improvement reliably in sleep problems after bilateral subthalamic nucleus DBS for PD.
In this prospective study, 25 consecutive patients undergoing DBS implantation were enrolled. Patients were examined twice: 1 week prior to the DBS implantation (baseline) and 12 months postoperatively. Severity of PD symptoms were assessed by the Movement Disorders Society Unified PD Rating Scale (MDS-UPDRS) and the Non-Motor Symptoms Scale (NMSS). Presence and severity of sleep disturbances were specifically measured by PDSS-2.
Total score of MDS-UPDRS improved from 81 (median, interquartile-range: 63-103) to 55 points (median, IQR: 46-75, p < 0.001). Health-related quality of life, measured by PDQ-39, also improved from 29 (IQR: 18-40) to 15 (IQR: 9-28) points (p = 0.002). Most domains of NMSS also improved. At baseline 13 patients reported sleep problems, but 1 year after DBS implantation only 3 did (p = 0.012). Although only 6 out of 15 items showed a significant decrease after DBS implantation, the total score of PDSS-2 decreased from 24 (IQR: 17-32) to 10 (IQR: 7-18) points (P < 0.001).
Based on our results, PDSS-2 can detect improvements in sleep quality reliably after DBS implantation.
睡眠问题是帕金森病（PD）最常见的非运动症状之一。PD 睡眠量表 2 版（PDSS-2）通过增加更多关于睡眠问题不同方面的项目，改进了原始 PDSS，使其成为评估睡眠障碍严重程度的更有力工具。然而，之前关于深部脑刺激（DBS）的研究并未使用 PDSS-2。
确定 PDSS-2 是否可以可靠地检测双侧丘脑底核 DBS 治疗 PD 后睡眠问题的改善。
在这项前瞻性研究中，纳入了 25 例连续接受 DBS 植入的患者。患者接受了两次检查：在 DBS 植入前 1 周（基线）和术后 12 个月。PD 症状的严重程度通过运动障碍协会统一 PD 评定量表（MDS-UPDRS）和非运动症状量表（NMSS）进行评估。PDSS-2 专门测量睡眠障碍的存在和严重程度。
MDS-UPDRS 的总分从 81 分（中位数，四分位距：63-103）改善至 55 分（中位数，四分位距：46-75，p ＜0.001）。PDQ-39 测量的健康相关生活质量也从 29 分（IQR：18-40）改善至 15 分（IQR：9-28）（p=0.002）。NMSS 的大多数领域也有所改善。在基线时，13 名患者报告有睡眠问题，但在 DBS 植入 1 年后，只有 3 名患者有睡眠问题（p=0.012）。尽管 DBS 植入后只有 6 项中的 15 项有显著下降，但 PDSS-2 的总分从 24 分（IQR：17-32）降至 10 分（IQR：7-18）（P＜0.001）。
根据我们的结果，PDSS-2 可以可靠地检测 DBS 植入后睡眠质量的改善。
