Effect of deep brain stimulation on autonomic dysfunction in patients with Parkinson's disease

Increasing attention is being paid to the non-motor symptoms of Parkinson's disease (PD). While deep brain stimulation (DBS) of the subthalamic nucleus (STN) has been shown to clearly improve motor symptoms of PD, the effects of STN DBS on autonomic symptoms have not been well studied. We examined 11 patients undergoing STN DBS for PD. Patients were administered a questionnaire by phone to evaluate pre-operative and post-operative function. Three out of the 11 patients reported marked improvement post-DBS in one or more symptoms of autonomic dysfunction (sweating, bladder, or bowel function). All three patients had early-onset PD (EOPD), whereas the eight patients reporting no significant improvement were those with late-onset PD. Thus, we found that some patients experienced marked improvement in sweating and/or bowel and bladder function after STN DBS, with a trend towards a response in patients with EOPD. Our results suggest the utility of a larger prospective study.