Nazan ŞİMŞEK ERDEM, Gokce Yagmur GUNES GENCER, Sehür Sibel ÖZKAYNAK, Tanju UÇAR

Parkinson Hastalarında Subtalamik Çekirdek Derin Beyin Stimülasyonu Tedavisinin Non-motor Semptomlara ve Uyku Kalitesine Etkisi

Amaç: Parkinson Hastalığı (PH) olan hastalarda subtalamik nukleus derin beyin stimülasyonunun (STN-DBS) non- motor semptomlar (NMS), uyku kalitesi ve gündüz aşırı uykululuk üzerine etkisini değerlendirmek. Yöntem: Bilateral STN-DBS cerrahisi geçirmiş 16 PH hastası çalışmaya alındı. Hastalar ameliyat öncesi ve ameliyattan 12 ay sonra Birleşik Parkinson Hastalığı Derecelendirme Ölçeği (BPHDÖ), Parkinson Hastalığı Anketi (PDQ-39), Beck Depresyon Envanteri-II (BDI), Hastane Anksiyete ve Depresyon Ölçeği (HADS), Pittsburgh Uyku Kalitesi İndeksi (PSQI), Epworth Uykululuk Ölçeği (ESS) ve Non-motor Semptom Anketi (NMS-Quest) kullanılarak değerlendirildi. Bulgular: Hastaların ameliyat anındaki ortalama yaşı 53,5±3,6 idi. DBS ameliyatından 12 ay sonra levodopa eşdeğeri günlük dozunda, BPHDÖ-bölüm-II, BPHDÖ-bölüm-III ve BPHDÖ-bölüm-IV'te anlamlı iyileşmeler oldu. Başlangıçtaki NMS-Quest toplam puanı, hastaların hastalık süresi ile koreleydi (p=0,005 R:0,66). Başlangıçtaki PSQI skoru, yüksek BPHDÖ toplam skor ve HADS skoru ile anlamlı şekilde ilişkiliydi (sırasıyla p=0.03, p=0.004). Başlangıçtaki ve DBS cerrahisinden 12 ay sonraki NMS-Quest toplam ve alt alanları, PSQI toplam puanı ve alt alanları, BPHDÖ-bölüm-I, BDI-II ve HADS puanları arasında anlamlı fark yoktu (p>0,05 tümü için ). Sonuç: STN-DBS cerrahisi motor semptomları, motor dalgalanmaları ve sağlıkla ilişkili yaşam kalitesini iyileştirmesine rağmen gündüz aşırı uykululuk halini, subjektif uyku kalitesini ve NMS'yi değiştirmedi.

Anahtar Kelimeler:

subtalamik nukleus derin beyin stimülasyonu (STN-DBS), uyku kalitesi, non- semptomlar, gündüz aşırı uykululuk hali

Effect of Subthalamic Nucleus Deep Brain Stimulation Treatment on Non-motor Symptoms and Sleep Quality in Parkinson’s Disease Patients

Aim: To evaluate the effect of subthalamic nucleus deep brain stimulation (STN-DBS) on non-motor symptoms (NMS), sleep quality, and excessive daytime sleepiness in patients with Parkinson’s Disease (PD). Method: Sixteen PD patients, who had undergone bilateral STN-DBS surgery were enrolled. The patients were assessed at the baseline and 12 months after surgery using the Unified Parkinson's Disease Rating Scale (UPDRS), Parkinson's Disease Questionnaire (PDQ-39), Beck Depression Inventory-II (BDI), Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Non-Motor Symptom Questionnaire (NMS-Quest). Results: The mean age of the patients at the time of surgery was 53.5±3.6 years. There were significant improvements in the levodopa-equivalent daily dose, UPDRS-part-II, UPDRS-part-III, and UPDRS-part-IV at 12 months post-DBS surgery. The NMS-Quest total score at baseline was correlated with the disease duration of the patients (p=0.005 R:0.66). The PSQI score at baseline was significantly associated with a high total UPDRS and HADS score (p=0.03, p=0.004 respectively). There were no significant differences in terms of NMS-Quest total and subdomains thereof and PSQI total score and subdomains thereof, UPDRS-part I, BDI-II and HADS scores between baseline and 12 months post-DBS surgery (p>0.05 for all of them). Conclusion: STN-DBS surgery did not change subjective sleep quality, excessive daytime sleepiness, and NMS although it improved motor symptoms, motor fluctuations, and the health-related quality of life

Keywords:

subthalamic nucleus deep brain stimulation (STN-DBS), sleep quality, non-motor symptoms, excessive daytime sleepiness,

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