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Suresh V, Dave T, Ghosh S, Jena R, Sanker V. Deep brain stimulation in Parkinson's disease: A scientometric and bibliometric analysis, trends, and research hotspots. Medicine (Baltimore) 2024; 103:e38152. [PMID: 38758903 PMCID: PMC11098246 DOI: 10.1097/md.0000000000038152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 04/16/2024] [Indexed: 05/19/2024] Open
Abstract
Parkinson disease (PD), a prevalent neurodegenerative ailment in the elderly, relies mainly on pharmacotherapy, yet deep brain stimulation (DBS) emerges as a vital remedy for refractory cases. This study performs a bibliometric analysis on DBS in PD, delving into research trends and study impact to offer comprehensive insights for researchers, clinicians, and policymakers, illuminating the current state and evolutionary trajectory of research in this domain. A systematic search on March 13, 2023, in the Scopus database utilized keywords like "Parkinson disease," "PD," "Parkinsonism," "Deep brain stimulation," and "DBS." The top 1000 highly cited publications on DBS in PD underwent scientometric analysis via VOS Viewer and R Studio's Bibliometrix package, covering publication characteristics, co-authorship, keyword co-occurrence, thematic clustering, and trend topics. The bibliometric analysis spanned 1984 to 2021, involving 1000 cited articles from 202 sources. The average number of citations per document were 140.9, with 31,854 references. "Movement Disorders" led in publications (n = 98), followed by "Brain" (n = 78) and "Neurology" (n = 65). The University of Oxford featured prominently. Thematic keyword clustering identified 9 core research areas, such as neuropsychological function and motor circuit electrophysiology. The shift from historical neurosurgical procedures to contemporary focuses like "beta oscillations" and "neuroethics" was evident. The bibliometric analysis emphasizes UK and US dominance, outlining 9 key research areas pivotal for reshaping Parkinson treatment. A discernible shift from invasive neurosurgery to DBS is observed. The call for personalized DBS, integration with NIBS, and exploration of innovative avenues marks the trajectory for future research.
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Affiliation(s)
- Vinay Suresh
- King George’s Medical University, Lucknow, India
| | - Tirth Dave
- Bukovinian State Medical University, Chernivtsi, Ukraine
| | | | - Rahul Jena
- Bharati Vidyapeeth Medical College, Pune, India
| | - Vivek Sanker
- Society of Brain Mapping and Therapeutics, Los Angeles, CA
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Zhao G, Cheng Y, Wang M, Wu Y, Yan J, Feng K, Yin S. Exploring the network effects of deep brain stimulation for rapid eye movement sleep behavior disorder in Parkinson's disease. Acta Neurochir (Wien) 2023; 165:3375-3384. [PMID: 37770797 DOI: 10.1007/s00701-023-05806-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 09/07/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND The research findings on the effects of subthalamic nucleus (STN) deep brain stimulation (DBS) in Parkinson's disease (PD) with Rapid Eye Movement Sleep Behavior Disorder (RBD) are inconsistent, and there is a lack of research on DBS electrode sites and their network effects for the explanation of the differences. Our objective is to explore the optimal stimulation sites (that is the sweet spot) and the brain network effects of STN-DBS for RBD in PD. METHODS In this study, among the 50 PD patients who underwent STN-DBS treatment, 24 PD patients with RBD were screened. According to clinical scores and imaging data, the sweet spot of STN-DBS was analyzed in PD patients with RBD, and the optimal structure and functional network models of subthalamic stimulation were constructed. RESULTS Bilateral STN-DBS can effectively improve the symptoms of RBD and other non-motor symptoms in 24 PD patients with RBD. RBD Questionnaire-Hong Kong (RBDQ-HK) score was 41.33 ± 17.45 at baseline and 30.83 ± 15.83 at 1-year follow-up, with statistical significance between them (P < 0.01). However, the MoCA score was an exception with a baseline of 22.04 ± 4.28 and a 1-year follow-up of 21.58 ± 4.33, showing no statistical significance (P = 0.12). The sweet spot and optimal network connectivity models for RBD improvement have been validated as effective. CONCLUSIONS Bilateral STN-DBS can improve the symptoms of RBD in PD. There exist the sweet spot and brain network effects of bilateral STN-DBS in the treatment of PD with RBD. Our study also demonstrates that RBD is a brain network disease.
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Affiliation(s)
- Guangrui Zhao
- Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, 300070, China
- Department of Neurosurgery, Lu'an Hospital Affiliated to Anhui Medical University, Lu'an, 237000, China
| | - Yifeng Cheng
- Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, 300070, China
- Department of Neurosurgery, Huanhu Hospital, Tianjin University, Tianjin, 300350, China
| | - Min Wang
- Department of Neurology, Huanhu Hospital, Tianjin University, Tianjin, 300350, China
| | - Yuzhang Wu
- Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, 300070, China
| | - Jingtao Yan
- Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, 300070, China
| | - Keke Feng
- Department of Neurosurgery, Huanhu Hospital, Tianjin University, Tianjin, 300350, China.
| | - Shaoya Yin
- Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, 300070, China.
- Department of Neurosurgery, Huanhu Hospital, Tianjin University, Tianjin, 300350, China.
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El Ghazal N, Nakanishi H, Martinez-Nunez AE, Al Sabbakh NK, Segun-Omosehin OA, Bourdakos NE, Nasser M, Matar RH, Than C, Danoun OA, Johnson A. The Effects of Deep Brain Stimulation on Mood and Quality of Life in Parkinson's Disease: A Systematic Review and Meta-Analysis. Cureus 2023; 15:e44177. [PMID: 37753046 PMCID: PMC10519648 DOI: 10.7759/cureus.44177] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2023] [Indexed: 09/28/2023] Open
Abstract
Deep brain stimulation (DBS) is extensively used to treat motor and non-motor symptoms in Parkinson's disease (PD). The aim of this study was to investigate the difference between subthalamic (STN) and globus pallidus internus (GPi) DBS on mood and quality of life with reference to minimal clinically important differences (MCID). A systematic literature search for articles published until November 2022 yielded 14 studies meeting the eligibility criteria, with a total of 1,088 patients undergoing STN (n=571) or GPi (n=517) stimulation. Baseline patient and clinical characteristics were comparable between the two groups. Results showed that GPi stimulation demonstrated a greater reduction in the Beck depression inventory (mean difference (MD)=1.68) than STN stimulation (MD=0.84). Hospital anxiety and depression scale showed a 2.69- and 3.48-point decrease by the GPi group in the depression and anxiety categories, respectively. The summary index (SI) of the PD questionnaire depicted a greater improvement in the GPi group from baseline (mean=41.01, 95% CI 34.89, 47.13) to follow-up (mean=30.85, 95% CI 22.08, 39.63) when compared to the STN group (baseline mean=42.43, 95% CI 34.50, 50.37; follow-up mean=34.21, 95% CI 25.43, 42.99). The emotions category also demonstrated a similar trend. However, STN stimulation showed greater reductions in motor symptoms and medication than GPi stimulation. This meta-analysis demonstrated that GPi stimulation seems to offer an advantage over STN stimulation in improving mood and quality of life in PD, but those effects must be further validated by larger studies.
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Affiliation(s)
- Nour El Ghazal
- Neurosurgery, St George's University of London, London, GBR
- Neurosurgery, University of Nicosia Medical School, Nicosia, CYP
| | - Hayato Nakanishi
- Neurosurgery, St George's University of London, London, GBR
- Neurosurgery, University of Nicosia Medical School, Nicosia, CYP
| | | | - Nader K Al Sabbakh
- Neurosurgery, St George's University of London, London, GBR
- Neurosurgery, University of Nicosia Medical School, Nicosia, CYP
| | - Omotayo A Segun-Omosehin
- Neurosurgery, St George's University of London, London, GBR
- Neurosurgery, University of Nicosia Medical School, Nicosia, CYP
| | - Natalie E Bourdakos
- Neurosurgery, St George's University of London, London, GBR
- Neurosurgery, University of Nicosia Medical School, Nicosia, CYP
| | - Maya Nasser
- Neurosurgery, St George's University of London, London, GBR
- Neurosurgery, University of Nicosia Medical School, Nicosia, CYP
| | - Reem H Matar
- Neurosurgery, St George's University of London, London, GBR
- Neurosurgery, University of Nicosia Medical School, Nicosia, CYP
- Gastroenterology and Hepatology, Mayo Clinic, Rochester, USA
| | - Christian Than
- Neurosurgery, St George's University of London, London, GBR
- Neurosurgery, University of Nicosia Medical School, Nicosia, CYP
- Biomedical Sciences, The University of Queensland, Brisbane, AUS
| | | | - Andrew Johnson
- Neurological Institute, Northshore Medical Group, Chicago, USA
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van Wamelen DJ, Rukavina K, Podlewska AM, Chaudhuri KR. Advances in the Pharmacological and Non-pharmacological Management of Non-motor Symptoms in Parkinson's Disease: An Update Since 2017. Curr Neuropharmacol 2023; 21:1786-1805. [PMID: 35293295 PMCID: PMC10514535 DOI: 10.2174/1570159x20666220315163856] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/19/2022] [Accepted: 03/10/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Non-motor symptoms (NMS) are an important and ubiquitous determinant of quality of life in Parkinson's disease (PD). However, robust evidence for their treatment is still a major unmet need. OBJECTIVE This study aimed to provide an updated review on advances in pharmacological, nonpharmacological, and exercise-based interventions for NMS in PD, covering the period since the publication of the MDS Task Force Recommendations. METHODS We performed a literature search to identify pharmacological, non-pharmacological, and exercise-based interventions for NMS in PD. As there are recent reviews on the subject, we have only included studies from the 1st of January 2017 to the 1st of December 2021 and limited our search to randomised and non-randomised (including open-label) clinical trials. RESULTS We discuss new strategies to manage NMS based on data that have become available since 2017, for instance, on the treatment of orthostatic hypotension with droxidopa, several dopaminergic treatment options for insomnia, and a range of non-pharmacological and exercise-based interventions for cognitive and neuropsychiatric symptoms, pain, and insomnia and excessive sleepiness. CONCLUSION Recent evidence suggests that targeted non-pharmacological treatments, as well as some other NMS management options, may have a significant beneficial effect on the quality of life and need to be considered in the pathways of treatment of PD.
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Affiliation(s)
- Daniel J. van Wamelen
- Department of Basic & Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, Division of Neuroscience, King’s College London, London, United Kingdom
- Parkinson Foundation Centre of Excellence at King’s College Hospital NHS Foundation Trust, London, United Kingdom
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behaviour, Centre of Expertise for Parkinson & Movement Disorders, Nijmegen, the Netherlands
| | - Katarina Rukavina
- Department of Basic & Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, Division of Neuroscience, King’s College London, London, United Kingdom
- Parkinson Foundation Centre of Excellence at King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Aleksandra M. Podlewska
- Department of Basic & Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, Division of Neuroscience, King’s College London, London, United Kingdom
- Parkinson Foundation Centre of Excellence at King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - K. Ray Chaudhuri
- Department of Basic & Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, Division of Neuroscience, King’s College London, London, United Kingdom
- Parkinson Foundation Centre of Excellence at King’s College Hospital NHS Foundation Trust, London, United Kingdom
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Schütz L, Sixel-Döring F, Hermann W. Management of Sleep Disturbances in Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2022; 12:2029-2058. [PMID: 35938257 PMCID: PMC9661340 DOI: 10.3233/jpd-212749] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/23/2022] [Indexed: 06/07/2023]
Abstract
Parkinson's disease (PD) is defined by its motor symptoms rigidity, tremor, and akinesia. However, non-motor symptoms, particularly autonomic disorders and sleep disturbances, occur frequently in PD causing equivalent or even greater discomfort than motor symptoms effectively decreasing quality of life in patients and caregivers. Most common sleep disturbances in PD are insomnia, sleep disordered breathing, excessive daytime sleepiness, REM sleep behavior disorder, and sleep-related movement disorders such as restless legs syndrome. Despite their high prevalence, therapeutic options in the in- and outpatient setting are limited, partly due to lack of scientific evidence. The importance of sleep disturbances in neurodegenerative diseases has been further emphasized by recent evidence indicating a bidirectional relationship between neurodegeneration and sleep. A more profound insight into the underlying pathophysiological mechanisms intertwining sleep and neurodegeneration might lead to unique and individually tailored disease modifying or even neuroprotective therapeutic options in the long run. Therefore, current evidence concerning the management of sleep disturbances in PD will be discussed with the aim of providing a substantiated scaffolding for clinical decisions in long-term PD therapy.
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Affiliation(s)
- Lukas Schütz
- Department of Neurology, University of Rostock, Rostock, Germany
| | | | - Wiebke Hermann
- Department of Neurology, University of Rostock, Rostock, Germany
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Personalised Advanced Therapies in Parkinson's Disease: The Role of Non-Motor Symptoms Profile. J Pers Med 2021; 11:jpm11080773. [PMID: 34442417 PMCID: PMC8400869 DOI: 10.3390/jpm11080773] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 07/25/2021] [Accepted: 07/26/2021] [Indexed: 12/22/2022] Open
Abstract
Device-aided therapies, including levodopa-carbidopa intestinal gel infusion, apomorphine subcutaneous infusion, and deep brain stimulation, are available in many countries for the management of the advanced stage of Parkinson’s disease (PD). Currently, selection of device-aided therapies is mainly focused on patients’ motor profile while non-motor symptoms play a role limited to being regarded as possible exclusion criteria in the decision-making process for the delivery and sustenance of a successful treatment. Differential beneficial effects on specific non-motor symptoms of the currently available device-aided therapies for PD are emerging and these could hold relevant clinical implications. In this viewpoint, we suggest that specific non-motor symptoms could be used as an additional anchor to motor symptoms and not merely as exclusion criteria to deliver bespoke and patient-specific personalised therapy for advanced PD.
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Yin Z, Bai Y, Guan B, Jiang Y, Wang Z, Meng F, Yang A, Zhang J. A quantitative analysis of the effect of bilateral subthalamic nucleus-deep brain stimulation on subjective and objective sleep parameters in Parkinson's disease. Sleep Med 2020; 79:195-204. [PMID: 33208282 DOI: 10.1016/j.sleep.2020.10.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 10/16/2020] [Accepted: 10/28/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To explore how subjective and objective sleep parameters respond to bilateral subthalamic nucleus-deep brain stimulation (STN-DBS) in patients with Parkinson's disease (PD). METHODS Thirty DBS sleep studies were included by searching PubMed, Embase, and the Cochrane Library, and only 21 prospectively designed studies, including 541 patients, were eligible for the main analysis. We evaluated sleep disturbance using 1 objective measurement, polysomnography (PSG), and 4 subjective scales, including PD Sleep Scale (PDSS), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and restless legs syndrome (RLS). We pooled data using the standard mean difference (SMD). The primary outcome was a change in sleep parameters 6 months postoperatively. Outcomes from <12 months to ≥12 months follow-up were compared in the subgroup analysis. Meta-regression was further conducted. RESULTS STN-DBS significantly improved all 4 subjective sleep scales in the 6-month follow-up: ESS (SMD = 0.234), PDSS (SMD = 0.724), PSQI (SMD = 1.374) and RLS (SMD = 1.086), while most PSG parameters remained unchanged, except for shortened rapid eye movement sleep latency (RSL) (SMD = 0.520). In the over-12-month follow-up, improvement persisted in PDSS but not in ESS. Dopamine drug reduction (p = 0.009) and motor improvement (p = 0.036) were correlated with ESS improvement and PDSS improvement, respectively. CONCLUSIONS Bilateral STN-DBS continuously improved subjective nocturnal sleep, while its effect on ESS lasted for only 1 year. Medication reduction and motor improvement may contribute to improved daytime sleepiness and better subjective nocturnal sleep, respectively. Except for a shortened RSL, STN-DBS did not change PSG parameters, including sleep efficiency and sleep architecture. REGISTRATION Open Science Framework: DOI 10.17605/OSF.IO/3EGRC.
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Affiliation(s)
- Zixiao Yin
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Yutong Bai
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Boyuan Guan
- Department of Neuropsychiatry, Behavioral Neurology and Sleep Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yin Jiang
- Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Zhan Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Fangang Meng
- Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Anchao Yang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neurostimulation, Beijing, China.
| | - Jianguo Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neurostimulation, Beijing, China.
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