Effect of subthalamic deep brain stimulation on the function of the urinary bladder
Annals of Neurology
Seif, C., J. Herzog, et al. (2004) Effect of subthalamic deep brain stimulation on the function of the urinary bladder Annals of Neurology, 55(1): 118-20
Urinary dysfunction is common with PD. A typical dysfunction is detrusor hyperreflexia (involuntary contractions of the bladder causing reduced capacity and early desire to void, also known as overactive bladder) which can cause urgent urination, increased urinary frequency, and urge incontinence. It is unclear what exactly causes detrusor hyperreflexia but these authors implicate that affected areas include dopamine (chemical in the brain) receptors, the substantia nigra, and basal ganglia. This study looked at 16 randomly chosen patients with PD (9 women, 7 men, mean age 62, disease duration 15 years) and DBS STN (6-29 months after implantation). It is notable that these patients did not necessarily have urinary dysfunction and all patients had a significant reduction in motor symptoms resultant from the DBS STN. They looked at multiple variables associated with urination during DBS STN OFF and ON without antiparkinsonian medications for 12 hours. They found that during the OFF phase patients showed Òtypical overactive bladderÓ a common sign of detrusor hyperreflexia in PD without DBS STN, which was not found during the ON phase. There were no differences between detrusor pressure, urine flow, or urine remaining in the bladder. They cite multiple hypotheses regarding anatomical reasons why DBS STN resulted in improved bladder functioning in PD.