Effects of subthalamic nucleus stimulation and levodopa on the autonomic nervous system in Parkinson’s disease.
Ludwig J, Remien P, Guballa C, Binder A, Binder S, Schattschneider J, Herzog J, Volkmann J, Deuschl G, Wasner G, Baron R. Effects of subthalamic nucleus stimulation and levodopa on the autonomic nervous system in Parkinson’s disease. , J Neurol Neurosurg Psychiatry. 2007 Jul;78(7):742-5. Epub 2007 Mar 19
This is a European study that looked at the effect of stimulator or medicinal treatment of PD on the autonomic nervous system (ANS; e.g. system in the body that controls heart rate, blood pressure, bladder control, temperature, etc.) of PWP. The authors looked at PWP with and without DBS as well as at different times of stimulation and medication administration (e.g. immediately after taking it, off vs. on times, etc.). The individuals that underwent DBS-STN were approximately 1-2 years out from the surgery and had significant improvement in their motor symptoms as well as a reduction in the amount of levodopa needed after surgery. The authors found that select ANS functions (enhanced blood flow to the skin, bladder functioning) were positively affected by DBS-STN but in general that the stimulator did not affect blood pressure or cardiac functioning. They also found that levodopa negatively affected select ANS functions (lowered heart rate, lowered blood pressure, increased temperature, decreased blood flow to the skin), which in turn increased problems with orthostatic hypotension (getting dizzy with positional change). The researchers concluded that DBS-STN resulted in improvement in motor functioning, lowered need for PD medications after surgery, and that the symptoms of ANS dysfunction were reduced as compared to the non-stimulated PWP.