Department of Neurology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Neurology and Movement Disorder Center, Parkinson Study Group and Neuroscience Research Institute, College of Medicine, Seoul National University, Seoul, Korea.
Curr Neuropharmacol. 2021;19(10):1716-1727. doi: 10.2174/1570159X19666210215115718.
Sleep-wake disturbances (SWD) are one of the most common non-motor symptoms in the 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.
睡眠-觉醒障碍(SWD)是帕金森病(PD)中最常见的非运动症状之一,可在运动症状出现之前,甚至在早期出现。深部脑刺激(DBS)是治疗晚期 PD 患者运动症状的一种已确立的方法。然而,DBS 对 SWD 的影响及其具体机制尚未得到广泛理解,仍存在争议。除了通过回路介导的直接作用外,DBS 还可以通过间接作用来改善 SWD,例如解决夜间运动并发症和减少多巴胺能药物治疗。在这里,作者回顾了最近关于 DBS 对 PD 患者 SWD 影响的文献。此外,还讨论了 DBS 靶点的选择以及将 DBS 应用于每个靶点对 PD 中 SWD 的具体影响。