Skip to main content
SpringerLink
Log in

Impact of Surgical Therapies on Sleep and Alertness in Parkinson’s Disease

  • Chapter
Disorders of Sleep and Circadian Rhythms in Parkinson's Disease

  • 1158 Accesses

Abstract

Surgical therapies for Parkinson’s disease (PD) play an increasingly important role in the treatment of motor symptoms that are refractory to medical management. These therapies include deep brain stimulation, lesional/ablation surgery of brain structures, and placement of an intrajejunal tube to administer continuous drug delivery of levodopa/carbidopa intestinal gel (LCIG). Sleep dysfunction and excessive daytime sleepiness are very common among patients with Parkinson’s disease and negatively impact quality of life. For this reason, understanding the impact of surgical therapies on these symptoms can provide additional insights into strategies for optimizing outcomes and provide a better understanding of the pathophysiology of sleep disorders in PD patients. In this chapter, we review the available data on the effects of surgical therapies on sleep architecture, sleep quality, and daytime vigilance and discuss the need for further study to fully understand the mechanisms underlying changes in sleep following surgical intervention.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Speelman JD, Bosch DA. Resurgence of functional neurosurgery for Parkinson’s disease: a historical perspective. Mov Disord. 1998;13(3):582–8. doi:10.1002/mds.870130336.

    Article  CAS  PubMed  Google Scholar 

  2. Hariz MI, Blomstedt P, Zrinzo L. Deep brain stimulation between 1947 and 1987: the untold story. Neurosurg Focus. 2010;29(2):E1. doi:10.3171/2010.4.FOCUS10106.

    Article  PubMed  Google Scholar 

  3. Bergman H, Wichmann T, DeLong MR. Reversal of experimental Parkinsonism by lesions of the subthalamic nucleus. Science. 1990;249(4975):1436–8.

    Article  CAS  PubMed  Google Scholar 

  4. Pollak P, Benabid AL, Gross C, Gao DM, Laurent A, Benazzouz A, Hoffmann D, Gentil M, Perret J. Effects of the stimulation of the subthalamic nucleus in Parkinson disease. Rev Neurol (Paris). 1993;149(3):175–6.

    CAS  Google Scholar 

  5. Sako W, Miyazaki Y, Izumi Y, Kaji R. Which target is best for patients with Parkinson’s disease? A meta-analysis of pallidal and subthalamic stimulation. J Neurol Neurosurg Psychiatry. 2014;85(9):982–6. doi:10.1136/jnnp-2013-306090.

    Article  PubMed  Google Scholar 

  6. Weaver FM, Follett K, Stern M, Hur K, Harris C, Marks Jr WJ, Rothlind J, Sagher O, Reda D, Moy CS, Pahwa R, Burchiel K, Hogarth P, Lai EC, Duda JE, Holloway K, Samii A, Horn S, Bronstein J, Stoner G, Heemskerk J, Huang GD. Bilateral deep brain stimulation versus best medical therapy for patients with advanced Parkinson’s disease: a randomized controlled trial. JAMA. 2009;301(1):63–73. doi:10.1001/jama.2008.929. 301/1/63 [pii].

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  7. Deuschl G, Schade-Brittinger C, Krack P, Volkmann J, Schafer H, Botzel K, Daniels C, Deutschlander A, Dillmann U, Eisner W, Gruber D, Hamel W, Herzog J, Hilker R, Klebe S, Kloss M, Koy J, Krause M, Kupsch A, Lorenz D, Lorenzl S, Mehdorn HM, Moringlane JR, Oertel W, Pinsker MO, Reichmann H, Reuss A, Schneider GH, Schnitzler A, Steude U, Sturm V, Timmermann L, Tronnier V, Trottenberg T, Wojtecki L, Wolf E, Poewe W, Voges J. A randomized trial of deep brain stimulation for Parkinson’s disease. N Engl J Med. 2006;355(9):896–908. doi:10.1056/NEJMoa060281. 355/9/896 [pii].

    Article  CAS  PubMed  Google Scholar 

  8. Williams A, Gill S, Varma T, Jenkinson C, Quinn N, Mitchell R, Scott R, Ives N, Rick C, Daniels J, Patel S, Wheatley K. Deep brain stimulation plus best medical therapy versus best medical therapy alone for advanced Parkinson’s disease (PD SURG trial): a randomised, open-label trial. Lancet Neurol. 2010;9(6):581–91. doi:10.1016/S1474-4422(10)70093-4. S1474-4422(10)70093-4 [pii].

    Article  PubMed Central  PubMed  Google Scholar 

  9. Walker HC, Watts RL, Guthrie S, Wang D, Guthrie BL. Bilateral effects of unilateral subthalamic deep brain stimulation on Parkinson’s disease at 1 year. Neurosurgery. 2009;65(2):302–9; discussion 309–10. doi:10.1227/01.NEU.0000349764.34211.74. 00006123-200908000-00011 [pii].

  10. Tabbal SD, Ushe M, Mink JW, Revilla FJ, Wernle AR, Hong M, Karimi M, Perlmutter JS. Unilateral subthalamic nucleus stimulation has a measurable ipsilateral effect on rigidity and bradykinesia in Parkinson disease. Exp Neurol. 2008;211(1):234–42. doi:10.1016/j.expneurol.2008.01.024. S0014-4886(08)00057-5 [pii].

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  11. Slowinski JL, Putzke JD, Uitti RJ, Lucas JA, Turk MF, Kall BA, Wharen RE. Unilateral deep brain stimulation of the subthalamic nucleus for Parkinson’s disease. J Neurosurg. 2007;106(4):626–32. doi:10.3171/jns.2007.106.4.626.

    Article  PubMed  Google Scholar 

  12. Arnulf I, Bejjani BP, Garma L, Bonnet AM, Houeto JL, Damier P, Derenne JP, Agid Y. Improvement of sleep architecture in Parkinson’s disease with subthalamic nucleus stimulation. Neurology. 2000;55(11):1732–4.

    Article  CAS  PubMed  Google Scholar 

  13. Iranzo A, Valldeoriola F, Santamaria J, Tolosa E, Rumia J. Sleep symptoms and polysomnographic architecture in advanced Parkinson’s disease after chronic bilateral subthalamic stimulation. J Neurol Neurosurg Psychiatry. 2002;72(5):661–4.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  14. Monaca C, Ozsancak C, Jacquesson JM, Poirot I, Blond S, Destee A, Guieu JD, Derambure P. Effects of bilateral subthalamic stimulation on sleep in Parkinson’s disease. J Neurol. 2004;251(2):214–8.

    Article  CAS  PubMed  Google Scholar 

  15. Merlino G, Lettieri C, Mondani M, Belgrado E, Devigili G, Mucchiut M, Rinaldo S, Craighero C, D'Auria S, Skrap M, Eleopra R. Microsubthalamotomy improves sleep in patients affected by advanced Parkinson’s disease. Sleep Med. 2014;15(6):637–41. doi:10.1016/j.sleep.2013.12.016.

    Article  PubMed  Google Scholar 

  16. Cicolin A, Lopiano L, Zibetti M, Torre E, Tavella A, Guastamacchia G, Terreni A, Makrydakis G, Fattori E, Lanotte MM, Bergamasco B, Mutani R. Effects of deep brain stimulation of the subthalamic nucleus on sleep architecture in parkinsonian patients. Sleep Med. 2004;5(2):207–10. doi:10.1016/j.sleep.2003.10.010. S1389945704000061 [pii].

    Article  PubMed  Google Scholar 

  17. Nishida N, Murakami T, Kadoh K, Tohge R, Yamanegi M, Saiki H, Ueda K, Matsumoto S, Ishikawa M, Takahashi JA, Toda H. Subthalamic nucleus deep brain stimulation restores normal rapid eye movement sleep in Parkinson’s disease. Mov Disord. 2011;26(13):2418–22. doi:10.1002/mds.23862.

    Article  PubMed  Google Scholar 

  18. Hjort N, Ostergaard K, Dupont E. Improvement of sleep quality in patients with advanced Parkinson’s disease treated with deep brain stimulation of the subthalamic nucleus. Mov Disord. 2004;19(2):196–9.

    Article  PubMed  Google Scholar 

  19. Lyons KE, Pahwa R. Effects of bilateral subthalamic nucleus stimulation on sleep, daytime sleepiness, and early morning dystonia in patients with Parkinson disease. J Neurosurg. 2006;104(4):502–5.

    Article  PubMed  Google Scholar 

  20. Zibetti M, Torre E, Cinquepalmi A, Rosso M, Ducati A, Bergamasco B, Lanotte M, Lopiano L. Motor and non-motor symptom follow-up in parkinsonian patients after deep brain stimulation of the subthalamic nucleus. Eur Neurol. 2007;58(4):218–23.

    Article  CAS  PubMed  Google Scholar 

  21. Amara AW, Standaert DG, Guthrie S, Cutter G, Watts RL, Walker H. Unilateral subthalamic nucleus deep brain stimulation improves sleep quality in Parkinson’s disease. Parkinsonism Relat Disord. 2012;18(1):63–8. doi:10.1016/j.parkreldis.2011.09.001. S1353-8020(11)00298-7 [pii].

    Article  PubMed Central  PubMed  Google Scholar 

  22. Chahine LM, Ahmed A, Sun Z. Effects of STN DBS for Parkinson’s disease on restless legs syndrome and other sleep-related measures. Parkinsonism Relat Disord. 2011;17(3):208–11. doi:10.1016/j.parkreldis.2010.11.017. S1353-8020(10)00297-X [pii].

    Article  CAS  PubMed  Google Scholar 

  23. Monaca C, Ozsancak C, Defebvre L, Blond S, Destee A, Guieu JD, Derambure P. Transient insomnia induced by high-frequency deep brain stimulation in Parkinson’s disease. Neurology. 2004;62(7):1232–3.

    Article  CAS  PubMed  Google Scholar 

  24. Follett KA, Weaver FM, Stern M, Hur K, Harris CL, Luo P, Marks Jr WJ, Rothlind J, Sagher O, Moy C, Pahwa R, Burchiel K, Hogarth P, Lai EC, Duda JE, Holloway K, Samii A, Horn S, Bronstein JM, Stoner G, Starr PA, Simpson R, Baltuch G, De Salles A, Huang GD, Reda DJ. Pallidal versus subthalamic deep brain stimulation for Parkinson’s disease. N Engl J Med. 2010;362(22):2077–91. doi:10.1056/NEJMoa0907083. 362/22/2077 [pii].

    Article  CAS  PubMed  Google Scholar 

  25. Weaver FM, Follett KA, Stern M, Luo P, Harris CL, Hur K, Marks Jr WJ, Rothlind J, Sagher O, Moy C, Pahwa R, Burchiel K, Hogarth P, Lai EC, Duda JE, Holloway K, Samii A, Horn S, Bronstein JM, Stoner G, Starr PA, Simpson R, Baltuch G, De Salles A, Huang GD, Reda DJ. Randomized trial of deep brain stimulation for Parkinson’s disease: thirty-six-month outcomes. Neurology. 2012;79(1):55–65. doi:10.1212/WNL.0b013e31825dcdc1. WNL.0b013e31825dcdc1 [pii].

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  26. Follett KA, Torres-Russotto D. Deep brain stimulation of globus pallidus interna, subthalamic nucleus, and pedunculopontine nucleus for PD: which target? Parkinsonism Relat Disord. 2012;18 Suppl 1:S165–7. doi:10.1016/S1353-8020(11)70051-7. S1353-8020(11)70051-7 [pii].

    Article  PubMed  Google Scholar 

  27. Odekerken VJ, van Laar T, Staal MJ, Mosch A, Hoffmann CF, Nijssen PC, Beute GN, van Vugt JP, Lenders MW, Contarino MF, Mink MS, Bour LJ, van den Munckhof P, Schmand BA, de Haan RJ, Schuurman PR, de Bie RM. Subthalamic nucleus versus globus pallidus bilateral deep brain stimulation for advanced Parkinson’s disease (NSTAPS study): a randomised controlled trial. Lancet Neurol. 2013;12(1):37–44. doi:10.1016/S1474-4422(12)70264-8. S1474-4422(12)70264-8 [pii].

    Article  PubMed  Google Scholar 

  28. Rodrigues JP, Walters SE, Watson P, Stell R, Mastaglia FL. Globus pallidus stimulation improves both motor and non-motor aspects of quality of life in advanced Parkinson’s disease. Mov Disord. 2007;22(13):1866–70. doi:10.1002/mds.21427.

    Article  PubMed  Google Scholar 

  29. Volkmann J, Albanese A, Kulisevsky J, Tornqvist AL, Houeto JL, Pidoux B, Bonnet AM, Mendes A, Benabid AL, Fraix V, Van Blercom N, Xie J, Obeso J, Rodriguez-Oroz MC, Guridi J, Schnitzler A, Timmermann L, Gironell AA, Molet J, Pascual-Sedano B, Rehncrona S, Moro E, Lang AC, Lozano AM, Bentivoglio AR, Scerrati M, Contarino MF, Romito L, Janssens M, Agid Y. Long-term effects of pallidal or subthalamic deep brain stimulation on quality of life in Parkinson’s disease. Mov Disord. 2009;24(8):1154–61.

    Article  PubMed  Google Scholar 

  30. Hariz MI, Krack P, Alesch F, Augustinsson LE, Bosch A, Ekberg R, Johansson F, Johnels B, Meyerson BA, N'Guyen JP, Pinter M, Pollak P, von Raison F, Rehncrona S, Speelman JD, Sydow O, Benabid AL. Multicentre European study of thalamic stimulation for parkinsonian tremor: a 6 year follow-up. J Neurol Neurosurg Psychiatry. 2008;79(6):694–9. doi:10.1136/jnnp.2007.118653. jnnp.2007.118653 [pii].

    Article  CAS  PubMed  Google Scholar 

  31. Arnulf I, Bejjani BP, Garma L, Bonnet AM, Damier P, Pidoux B, Dormont D, Cornu P, Derenne JP, Agid Y. Effect of low and high frequency thalamic stimulation on sleep in patients with Parkinson’s disease and essential tremor. J Sleep Res. 2000;9(1):55–62. jsr171 [pii].

    Article  CAS  PubMed  Google Scholar 

  32. Mazzone P, Lozano A, Stanzione P, Galati S, Scarnati E, Peppe A, Stefani A. Implantation of human pedunculopontine nucleus: a safe and clinically relevant target in Parkinson’s disease. Neuroreport. 2005;16(17):1877–81. 00001756-200511280-00002 [pii].

    Article  PubMed  Google Scholar 

  33. Plaha P, Gill SS. Bilateral deep brain stimulation of the pedunculopontine nucleus for Parkinson’s disease. Neuroreport. 2005;16(17):1883–7. 00001756-200511280-00003 [pii].

    Article  PubMed  Google Scholar 

  34. Stefani A, Lozano AM, Peppe A, Stanzione P, Galati S, Tropepi D, Pierantozzi M, Brusa L, Scarnati E, Mazzone P. Bilateral deep brain stimulation of the pedunculopontine and subthalamic nuclei in severe Parkinson’s disease. Brain. 2007;130(Pt 6):1596–607. doi:10.1093/brain/awl346. awl346 [pii].

    Article  PubMed  Google Scholar 

  35. Moro E, Hamani C, Poon YY, Al-Khairallah T, Dostrovsky JO, Hutchison WD, Lozano AM. Unilateral pedunculopontine stimulation improves falls in Parkinson’s disease. Brain. 2010;133(Pt 1):215–24. doi:10.1093/brain/awp261. awp261 [pii].

    Article  PubMed  Google Scholar 

  36. Ferraye MU, Debu B, Fraix V, Goetz L, Ardouin C, Yelnik J, Henry-Lagrange C, Seigneuret E, Piallat B, Krack P, Le Bas JF, Benabid AL, Chabardes S, Pollak P. Effects of pedunculopontine nucleus area stimulation on gait disorders in Parkinson’s disease. Brain. 2010;133(Pt 1):205–14. doi:10.1093/brain/awp229. awp229 [pii].

    Article  CAS  PubMed  Google Scholar 

  37. Khan S, Mooney L, Plaha P, Javed S, White P, Whone AL, Gill SS. Outcomes from stimulation of the caudal zona incerta and pedunculopontine nucleus in patients with Parkinson’s disease. Br J Neurosurg. 2011;25(2):273–80. doi:10.3109/02688697.2010.544790.

    Article  PubMed  Google Scholar 

  38. Romigi A, Placidi F, Peppe A, Pierantozzi M, Izzi F, Brusa L, Galati S, Moschella V, Marciani MG, Mazzone P, Stanzione P, Stefani A. Pedunculopontine nucleus stimulation influences rapid eye movement sleep in Parkinson’s disease. Eur J Neurol. 2008;15(7):e64–5. doi:10.1111/j.1468-1331.2008.02167.x. ENE2167 [pii].

    Article  CAS  PubMed  Google Scholar 

  39. Peppe A, Pierantozzi M, Baiamonte V, Moschella V, Caltagirone C, Stanzione P, Stefani A. Deep brain stimulation of pedunculopontine tegmental nucleus: role in sleep modulation in advanced Parkinson’s disease patients: one-year follow-up. Sleep. 2012;35(12):1637–42. doi:10.5665/sleep.2234.

    PubMed Central  PubMed  Google Scholar 

  40. Lim AS, Moro E, Lozano AM, Hamani C, Dostrovsky JO, Hutchison WD, Lang AE, Wennberg RA, Murray BJ. Selective enhancement of rapid eye movement sleep by deep brain stimulation of the human pons. Ann Neurol. 2009;66(1):110–4.

    Article  PubMed  Google Scholar 

  41. Arnulf I, Ferraye M, Fraix V, Benabid AL, Chabardes S, Goetz L, Pollak P, Debu B. Sleep induced by stimulation in the human pedunculopontine nucleus area. Ann Neurol. 2010;67(4):546–9. doi:10.1002/ana.21912.

    Article  PubMed  Google Scholar 

  42. Hariz M. Twenty-five years of deep brain stimulation: celebrations and apprehensions. Mov Disord. 2012;27(7):930–3. doi:10.1002/mds.25007.

    Article  PubMed  Google Scholar 

  43. Elias WJ, Huss D, Voss T, Loomba J, Khaled M, Zadicario E, Frysinger RC, Sperling SA, Wylie S, Monteith SJ, Druzgal J, Shah BB, Harrison M, Wintermark M. A pilot study of focused ultrasound thalamotomy for essential tremor. N Engl J Med. 2013;369(7):640–8. doi:10.1056/NEJMoa1300962.

    Article  CAS  PubMed  Google Scholar 

  44. Bricolo A. Insomnia after bilateral stereotactic thalamotomy in man. J Neurol Neurosurg Psychiatry. 1967;30(2):154–8.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  45. Quigg M, Frysinger RC, Harrison M, Elias WJ. Acute insomnia following surgery of the ventralis intermedius nucleus of the thalamus for tremor. J Clin Sleep Med. 2007;3(1):58–9.

    PubMed  Google Scholar 

  46. Roth C, Jeanmonod D, Magnin M, Morel A, Achermann P. Effects of medial thalamotomy and pallido-thalamic tractotomy on sleep and waking EEG in pain and Parkinsonian patients. Clin Neurophysiol. 2000;111(7):1266–75. S1388-2457(00)00295-9 [pii].

    Article  CAS  PubMed  Google Scholar 

  47. Favre J, Burchiel KJ, Taha JM, Hammerstad J. Outcome of unilateral and bilateral pallidotomy for Parkinson’s disease: patient assessment. Neurosurgery. 2000;46(2):344–53; discussion 353–5.

    Article  CAS  PubMed  Google Scholar 

  48. Nyholm D, Askmark H, Gomes-Trolin C, Knutson T, Lennernas H, Nystrom C, Aquilonius SM. Optimizing levodopa pharmacokinetics: intestinal infusion versus oral sustained-release tablets. Clin Neuropharmacol. 2003;26(3):156–63.

    Article  CAS  PubMed  Google Scholar 

  49. Honig H, Antonini A, Martinez-Martin P, Forgacs I, Faye GC, Fox T, Fox K, Mancini F, Canesi M, Odin P, Chaudhuri KR. Intrajejunal levodopa infusion in Parkinson’s disease: a pilot multicenter study of effects on non-motor symptoms and quality of life. Mov Disord. 2009;24(10):1468–74. doi:10.1002/mds.22596.

    Article  PubMed  Google Scholar 

  50. Fasano A, Ricciardi L, Lena F, Bentivoglio AR, Modugno N. Intrajejunal levodopa infusion in advanced Parkinson’s disease: long-term effects on motor and non-motor symptoms and impact on patient’s and caregiver’s quality of life. Eur Rev Med Pharmacol Sci. 2012;16(1):79–89.

    CAS  PubMed  Google Scholar 

  51. Zibetti M, Rizzone M, Merola A, Angrisano S, Rizzi L, Montanaro E, Cicolin A, Lopiano L. Sleep improvement with levodopa/carbidopa intestinal gel infusion in Parkinson’s disease. Acta Neurol Scand. 2013;127(5):e28–32. doi:10.1111/ane.12075.

    Article  CAS  PubMed  Google Scholar 

  52. Amara AW, Watts RL, Walker HC. The effects of deep brain stimulation on sleep in Parkinson’s disease. Ther Adv Neurol Disord. 2011;4(1):15–24. doi:10.1177/1756285610392446.

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported in part by the Francis and Ingeborg Heide Schumann Fellowship in Parkinson’s Disease Research (AA) and the Sartain Lanier Family Foundation (HW), and grant funding from the NIH NINDS K23NS080912 (AW) and NIH NINDS K23NS067053 (HW), and the American Sleep Medicine Foundation (AW). We would also like to sincerely thank Anthony Nicholas for contributing the content of Fig. 15.1.

Author information

Authors and Affiliations

  1. Division of Movement Disorders, Department of Neurology, UAB Sleep/Wake Disorders Center, University of Alabama at Birmingham, Birmingham, AL, USA

    Amy W. Amara

  2. Division of Movement Disorders, Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA

    Harrison C. Walker

Authors
  1. Amy W. Amara
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Harrison C. Walker
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Amy W. Amara .

Editor information

Editors and Affiliations

  1. Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA

    Aleksandar Videnovic

  2. Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria

    Birgit Högl

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag Wien

About this chapter

Cite this chapter

Amara, A.W., Walker, H.C. (2015). Impact of Surgical Therapies on Sleep and Alertness in Parkinson’s Disease. In: Videnovic, A., Högl, B. (eds) Disorders of Sleep and Circadian Rhythms in Parkinson's Disease. Springer, Vienna. https://doi.org/10.1007/978-3-7091-1631-9_15

Download citation

  • DOI: https://doi.org/10.1007/978-3-7091-1631-9_15

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-1630-2

  • Online ISBN: 978-3-7091-1631-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation