Current Science Review

Please note that the information contained in our CSR is for educational purposes only and is not intended as medical advice.

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Current Science Review — Jan/Feb 2010

Our Current Science Review ("CSR") is designed to summarize the most recent research on DBS-STN to the general public in a comprehensive, yet simplified fashion. The CSR will be updated monthly to keep you informed of DBS-STN advances.

The idea for our CSR is structured after the valuable service that Joe Bruman offered to the Parkinson's community. In 1994, when the Web was in its infancy, Joe began publishing an easy-to-read overview of published science and medical news on Parkinson's disease. He updated it monthly until his death in 2003. We acknowledge Joe's contribution, and our researchers are continuing his tradition for the DBS-STN community. As Joe as elequently states on his site, "CSR items describe current work which may or may NOT prove to be important. Each one is just a piece of the big PD jigsaw puzzle. … CSR provides an inkling of where we are, what lies ahead."

Stefani A, Roberto C, Livia B, Mariangela P, Alberto C, Salvatore G, Fabio P, Andrea R, Cesare I, Francesco M, Antonella P. (2009). Non-motor functions in parkinsonian patients implanted in the pedunculopontine nucleus: Focus on sleep and cognitive domains.. , J Neurol Sci. 2009 Sep 16. [Epub ahead of print].

Click here to read a longer version of this review.

This is a follow-up article from an earlier study (see citation below) that looked at the efficacy of bilateral deep brain stimulation of both the Subthalamic Nucleus (STN) and the Pedunculopontine (PPN; another target under evaluation for the surgical treatment of PD).  The researchers initially wanted to look at the efficacy of both targets combined on motor functioning in the person with Parkinson ’s disease (PWP).  Their findings suggested that both targets were effective in reducing motor difficulties but more so for DBS-STN (STN 54% vs. PPN 32% improvement).  The follow-up study focused on how this dual-targeted treatment affects various non-motor functions in the PWP, specifically sleep and cognition.  The authors found that all six of the patients were classified as poor sleepers but with the PPN and STN in specific settings, patients had an increase in the quality of nighttime sleep as compared to DBS-STN settings alone.  Patients also reported less “restlessness, psychosis, and daytime sleepiness.”  In regard to cognitive functioning, the patients were found to have better working memory, executive functioning, response times, and delayed memory with various settings of the PPN as compared to when the PPN stimulator settings were off.  Metabolism changes in various frontal lobe brain areas were also found and discussed (we would refer the reader to the article for those details).  The authors purported that although the DBS-PPN was not as efficacious as the DBS-STN for motor improvement, it did have less cognitive side effects, which suggests it may be used as an alternative for patients that do not qualify for STN due to existing cognitive deficits.  They noted that research must continue to look into how the DBS works in various sites in the brain as well as maximizing the PWP’s quality of life as well as reduction in motor difficulties.

Original study:  Alessandro Stefani, Andres M. Lozano, Antonella Peppe, Paolo Stanzione, Salvatore Galati, Domenicantonio Tropepi, Mariangela Pierantozzi, Livia Brusa, Eugenio Scarnati, and Paolo Mazzone (2007).  Bilateral deep brain stimulation of the pedunculopontine and subthalamic nuclei in severe Parkinson’s disease.  Brain (2007), 130, 1596-1607.

http://brain.oxfordjournals.org/cgi/reprint/130/6/1596 or http://www.ncbi.nlm.nih.gov/pubmed/17251240?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=2

Click here for the PubMed Abstract