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Dyspnea after subthalamic deep brain stimulation in Parkinson’s disease: a case–control study

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Abstract

Objective

Dyspnea can be present as non-motor symptom in patients with Parkinson’s disease (PD). Deep brain stimulation (DBS) of the subthalamic nucleus (STN) improves motor and non-motor symptoms in PD. However, new-onset dyspnea has been reported after DBS surgery. We have studied respiratory characteristics of PD patients with bilateral STN-DBS to assess the impact of DBS on pulmonary function.

Methods

STN-DBS PD patients with dyspnea after surgery (cases) were matched with STN-DBS PD patients without dyspnea (controls). Motor and pulmonary function were assessed with stimulation and without medication (on stim/off med), and without stimulation and medication (off stim/off med). Pulmonary function was investigated with spirometry and dyspnea with the Medical Research Council Dyspnea Scale (MRCDS) and the Borg Scale (BS).

Results

Seven cases (five men, 58.30 ± 6.70 years of age) and seven controls (six men, 61.10 ± 6.30 years of age) were enrolled. MRCDS and BS revealed the presence of dyspnea in both groups. No significant changes in pulmonary function were found in both cases and controls in on stim/off med vs. off stim/off med condition (p < 0.05), and in cases vs. controls in on stim/ off med condition (p < 0.05).

Conclusions

No impact of STN-DBS on pulmonary function was found in cases. Impaired perception of dyspnea and spread of stimulation surrounding the STN might account for new-onset dyspnea after DBS surgery. Dyspnea was detected also in controls using ad hoc questionnaires. Our findings suggest further investigation of this non-motor symptom in PD patients.

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Acknowledgements

The authors thank Dr. Kenneth R. Chapman, MD, Asthma and Airway Centre, Toronto Western Hospital, UHN, University of Toronto, Toronto, Ontario, Canada, for his help in supervising respiratory data collection. The authors also thank Christopher Meaney, Toronto Western Hospital, UHN, University of Toronto, Toronto, Ontario, Canada, for his help in statistical analysis of data

Author information

Authors and Affiliations

  1. Movement Disorders Unit, Division of Neurology, CHU Grenoble Alpes, Grenoble, France

    Sara Meoni & Elena Moro

  2. Grenoble Institute of Neurosciences, University Grenoble Alpes, INSERM, U1216, Grenoble, France

    Sara Meoni & Elena Moro

  3. University of Ottawa, Ottawa, ON, Canada

    Ana C. Bradi

  4. Department of Medicine, Queensway Carleton Hospital, Ottawa, ON, Canada

    Ana C. Bradi

  5. Movement Disorders Center, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada

    Pettarusp Wadia, Yu-Yan Poon & Elena Moro

  6. Movement Disorders Clinic, Jaslok Hospital and Research Centre, Mumbai, India

    Pettarusp Wadia

  7. Service de Neurologie, Centre Hospitalier Universitaire de Grenoble, BP 217, 38043, Grenoble Cedex 09, France

    Elena Moro

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  1. Sara Meoni
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  2. Ana C. Bradi
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Corresponding author

Correspondence to Elena Moro.

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Conflicts of interest

Sara Meoni reports no disclosures. Ana C. Bradi reports no disclosures. Pettarusp Wadia reports no disclosures. Yu-Yan Poon reports no disclosures. Elena Moro has received honoraria from Abbott, Medtronic and Newronika for consulting service and lecturing.

Ethical approval

The study was approved by the Research Ethics Board of the University Health Network, Toronto, Ontario, Canada. All subjects could understand the details of the study and gave informed consent to participate.

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Meoni, S., Bradi, A.C., Wadia, P. et al. Dyspnea after subthalamic deep brain stimulation in Parkinson’s disease: a case–control study. J Neurol 267, 3054–3060 (2020). https://doi.org/10.1007/s00415-020-09976-0

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  • DOI: https://doi.org/10.1007/s00415-020-09976-0

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