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Improvement of sleep architecture in PD with subthalamic nucleus stimulation

From the Centre d’Investigation Clinique, Fédération de Neurologie and INSERM U289 (Drs. Agid, Arnulf, Bejjani, Bonnet, Houeto, and Damier), UPRESS EA 2397 (Drs. Arnulf and Derenne), and Service d’Explorations Fonctionnelles du Système Nerveux (Dr. Garma), Hôpital Pitié-Salpêtrière, Paris, France.

Address correspondence and reprint requests to Dr. I. Arnulf, Pavillon Rambuteau, Hôpital Pitié-Salpêtrière, 47- 83 Boulevard de l’Hôpital, 75651 Paris Cedex 13, France; e-mail: isabelle.arnulf{at}psl.ap-hop-paris.fr

High-frequency stimulation of the subthalamic nucleus (STN) was used to investigate the relationship of sleep disorders with motor handicap in PD. In 10 insomniac patients with PD, stimulation reduced nighttime akinesia by 60% and completely suppressed axial and early morning dystonia, but did not alleviate periodic leg movements (n = 3) or REM sleep behavior disorders (n = 5). Total sleep time increased by 47%; wakefulness after sleep onset decreased by 51 minutes. Insomnia in patients with PD may predominantly result from nighttime motor disability.

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