Zheng Zhaoting, Liu Defeng, Fan Houyou, Xie Hutao, Zhang Quan, Qin Guofan, Jiang Yin, Meng Fangang, Yin Zixiao, Yang Anchao, Zhang Jianguo
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Beijing Key Laboratory of Neurostimulation, Beijing, China.
NPJ Parkinsons Dis. 2024 Nov 4;10(1):212. doi: 10.1038/s41531-024-00800-4.
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.
睡眠障碍影响多达98%的帕金森病（PD）患者，且往往治疗效果不佳。苍白球内侧部（GPi）脑深部电刺激（DBS）如何发挥作用尚鲜为人知。我们对32例接受GPi-DBS治疗且随访两年的PD患者的睡眠结果进行了回顾性分析。我们观察到睡眠对苍白球刺激的反应存在高度异质性：16例患者显示出具有临床意义的改善，9例有轻微变化，7例睡眠质量恶化，帕金森病睡眠量表-2（PDSS-2）总体无显著变化（P = 0.19）。进一步分析显示，左侧感觉运动苍白球的刺激与睡眠改善显著相关。从左侧感觉运动苍白球到双侧感觉运动皮层、右侧苍白球、脑干和双侧小脑的纤维束与更好的睡眠有关，而投射到左侧海马体则与睡眠恶化相关。这些发现可能指导个性化的GPi-DBS电极植入，以优化PD患者的睡眠结果。
