The Consequences of Bilateral Chronic Stimulation of Subthalamic Nucleus on Autonomic Function

• Main Authors: Kang-Du Liu, 劉康渡
• Other Authors: Terry B.J. Kuo
• Format: Others
• Language: en_US
• Published: 2009
• Online Access: http://ndltd.ncl.edu.tw/handle/pceeyd

碩士 === 國立陽明大學 === 腦科學研究所 === 97 === Dysfunctions of the autonomic nervous system (ANS) are common in Parkinson's disease (PD). Subthalamic nucleus (STN) stimulation has become an alternative treatment for advanced PD. The beneficial effects of STN stimulation on motor symptoms and quality of life are well known, but little is known of the effects on autonomic function. Based on the fact that diffusion of current during stimulation of the STN may simultaneously involve the motor and non-motor, limbic and associative areas of the STN, the aims of this study were to examine whether STN stimulation has an influence on functions of the ANS and, if so, to correlate these effects with the active contacts of electrodes in the STN. Eight PD patients with good motor control and quality of sleep after STN-DBS surgery were recruited for the study. All patients had 2 days of recordings with portable polysomnography (PSG) (first night with stimulation “ON” and second night “OFF”) in the hospital. From the PSG data, the first sleep cycle of each recording night was defined. Heart rate variability (HRV) was analyzed between the same uninterrupted periods of the two sleep nights. In addition, the optimal electrode positions were defined from postoperative MRI studies and the coordinates of active contacts were confirmed. The results of HRV spectral analysis showed that only the ratio of low-frequency to high-frequency power (LF/HF) was significantly activated in the stimulation “on” groups (P<0.001). Regarding the position of the electrode, in patients whose active contact of electrode was located more medial, the LF/HF power was much activated during stimulation (P=0.008). These results demonstrate that STN-DBS can enhance sympathetic regulation, and that the sympathetic response may be due to the activation of the limbic portion of the STN or descending sympathetic pathways in the zona incerta.