Short term cardiovascular symptoms improvement after deep brain stimulation in patients with Parkinson's disease: a systematic review
Background Autonomic dysfunction is common and disabling in Parkinson's disease (PD). The effects of deep brain stimulation (DBS) on the cardiovascular system in PD remain poorly understood. We aimed to assess the effect of DBS on cardiovascular symptoms and objective measures in PD patients. M...
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| Veröffentlicht in: | Journal of neurology 2024-07, Vol.271 (7), p.3764-3776 |
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| creator | Cucinotta, Francescopaolo Swinnen, Bart Makovac, Elena Hirschbichler, Stephanie Pereira, Erlick Little, Simon Morgante, Francesca Ricciardi, Lucia |
| description | Background
Autonomic dysfunction is common and disabling in Parkinson's disease (PD). The effects of deep brain stimulation (DBS) on the cardiovascular system in PD remain poorly understood. We aimed to assess the effect of DBS on cardiovascular symptoms and objective measures in PD patients.
Methods
We conducted a systematic literature search in PubMed/MEDLINE.
Results
36 out of 472 studies were included, mostly involving DBS of the subthalamic nucleus, and to a lesser extent the globus pallidus pars interna and pedunculopontine nucleus. Seventeen studies evaluated the effect of DBS on patient-reported or clinician-rated cardiovascular symptoms, showing an improvement in the first year after surgery but not with longer-term follow-up. DBS has no clear direct effects on blood pressure during an orthostatic challenge (n = 10 studies). DBS has inconsistent effects on heart rate variability (n = 10 studies).
Conclusion
Current evidence on the impact of DBS on cardiovascular functions in PD is inconclusive. DBS may offer short-term improvement of cardiovascular symptoms in PD, particularly orthostatic hypotension, which may be attributed to dopaminergic medication reduction after surgery. There is insufficient evidence to draw conclusions on the direct effect of DBS on blood pressure and heart rate variability. |
| doi_str_mv | 10.1007/s00415-024-12459-1 |
| format | Article |
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Autonomic dysfunction is common and disabling in Parkinson's disease (PD). The effects of deep brain stimulation (DBS) on the cardiovascular system in PD remain poorly understood. We aimed to assess the effect of DBS on cardiovascular symptoms and objective measures in PD patients.
Methods
We conducted a systematic literature search in PubMed/MEDLINE.
Results
36 out of 472 studies were included, mostly involving DBS of the subthalamic nucleus, and to a lesser extent the globus pallidus pars interna and pedunculopontine nucleus. Seventeen studies evaluated the effect of DBS on patient-reported or clinician-rated cardiovascular symptoms, showing an improvement in the first year after surgery but not with longer-term follow-up. DBS has no clear direct effects on blood pressure during an orthostatic challenge (n = 10 studies). DBS has inconsistent effects on heart rate variability (n = 10 studies).
Conclusion
Current evidence on the impact of DBS on cardiovascular functions in PD is inconclusive. DBS may offer short-term improvement of cardiovascular symptoms in PD, particularly orthostatic hypotension, which may be attributed to dopaminergic medication reduction after surgery. There is insufficient evidence to draw conclusions on the direct effect of DBS on blood pressure and heart rate variability.</description><identifier>ISSN: 0340-5354</identifier><identifier>ISSN: 1432-1459</identifier><identifier>EISSN: 1432-1459</identifier><identifier>DOI: 10.1007/s00415-024-12459-1</identifier><identifier>PMID: 38809271</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Blood pressure ; Blood Pressure - physiology ; Cardiovascular Diseases - etiology ; Cardiovascular Diseases - physiopathology ; Cardiovascular Diseases - therapy ; Cardiovascular system ; Deep brain stimulation ; Deep Brain Stimulation - methods ; Dopamine receptors ; Globus pallidus ; Heart rate ; Humans ; Hypotension ; Medicine ; Medicine & Public Health ; Movement disorders ; Neurodegenerative diseases ; Neurology ; Neuroradiology ; Neurosciences ; Parkinson Disease - complications ; Parkinson Disease - physiopathology ; Parkinson Disease - therapy ; Parkinson's disease ; Pedunculopontine tegmental nucleus ; Review ; Subthalamic nucleus ; Surgery</subject><ispartof>Journal of neurology, 2024-07, Vol.271 (7), p.3764-3776</ispartof><rights>The Author(s) 2024</rights><rights>2024. The Author(s).</rights><rights>The Author(s) 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c356t-1c7fc6351bc1b3135febde7398011a90018f3f4befab8903bae0b97cc1d57e253</cites><orcidid>0000-0001-9401-3301</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00415-024-12459-1$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00415-024-12459-1$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38809271$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cucinotta, Francescopaolo</creatorcontrib><creatorcontrib>Swinnen, Bart</creatorcontrib><creatorcontrib>Makovac, Elena</creatorcontrib><creatorcontrib>Hirschbichler, Stephanie</creatorcontrib><creatorcontrib>Pereira, Erlick</creatorcontrib><creatorcontrib>Little, Simon</creatorcontrib><creatorcontrib>Morgante, Francesca</creatorcontrib><creatorcontrib>Ricciardi, Lucia</creatorcontrib><title>Short term cardiovascular symptoms improvement after deep brain stimulation in patients with Parkinson's disease: a systematic review</title><title>Journal of neurology</title><addtitle>J Neurol</addtitle><addtitle>J Neurol</addtitle><description>Background
Autonomic dysfunction is common and disabling in Parkinson's disease (PD). The effects of deep brain stimulation (DBS) on the cardiovascular system in PD remain poorly understood. We aimed to assess the effect of DBS on cardiovascular symptoms and objective measures in PD patients.
Methods
We conducted a systematic literature search in PubMed/MEDLINE.
Results
36 out of 472 studies were included, mostly involving DBS of the subthalamic nucleus, and to a lesser extent the globus pallidus pars interna and pedunculopontine nucleus. Seventeen studies evaluated the effect of DBS on patient-reported or clinician-rated cardiovascular symptoms, showing an improvement in the first year after surgery but not with longer-term follow-up. DBS has no clear direct effects on blood pressure during an orthostatic challenge (n = 10 studies). DBS has inconsistent effects on heart rate variability (n = 10 studies).
Conclusion
Current evidence on the impact of DBS on cardiovascular functions in PD is inconclusive. DBS may offer short-term improvement of cardiovascular symptoms in PD, particularly orthostatic hypotension, which may be attributed to dopaminergic medication reduction after surgery. There is insufficient evidence to draw conclusions on the direct effect of DBS on blood pressure and heart rate variability.</description><subject>Blood pressure</subject><subject>Blood Pressure - physiology</subject><subject>Cardiovascular Diseases - etiology</subject><subject>Cardiovascular Diseases - physiopathology</subject><subject>Cardiovascular Diseases - therapy</subject><subject>Cardiovascular system</subject><subject>Deep brain stimulation</subject><subject>Deep Brain Stimulation - methods</subject><subject>Dopamine receptors</subject><subject>Globus pallidus</subject><subject>Heart rate</subject><subject>Humans</subject><subject>Hypotension</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Movement disorders</subject><subject>Neurodegenerative diseases</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Parkinson Disease - complications</subject><subject>Parkinson Disease - physiopathology</subject><subject>Parkinson Disease - therapy</subject><subject>Parkinson's disease</subject><subject>Pedunculopontine tegmental nucleus</subject><subject>Review</subject><subject>Subthalamic nucleus</subject><subject>Surgery</subject><issn>0340-5354</issn><issn>1432-1459</issn><issn>1432-1459</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9kc1u1TAQhS0EopfCC7BAlljAJjATx9cJmwpV_EmVQALWluNMel3iONjOrfoAvDeGW8rPgpU9Ot-cmdFh7CHCMwRQzxNAg7KCuqmwbmRX4S22wUbUFZbqNtuAaKCSQjZH7F5KFwDQFuEuOxJtC12tcMO-fdyFmHmm6Lk1cXBhb5JdJxN5uvJLDj5x55cY9uRpztyMBeUD0cL7aNzMU3a-4NmFmZdyKb_CJX7p8o5_MPGLm1OYnyQ-uEQm0QtuinPK5AtpeaS9o8v77M5opkQPrt9j9vn1q0-nb6uz92_enb48q6yQ21yhVaPdCom9xV6gkCP1AynRtYBoOgBsRzE2PY2mbzsQvSHoO2UtDlJRLcUxOzn4LmvvabBl02gmvUTnTbzSwTj9tzK7nT4Pe41YCyGgLQ5Prx1i-LpSytq7ZGmazExhTVrAFlXblDgK-vgf9CKscS73FUopqWrArlD1gbIxpBRpvNkGQf-IWR9i1iVm_TNmjaXp0Z933LT8yrUA4gCkIs3nFH_P_o_td1SitzM</recordid><startdate>20240701</startdate><enddate>20240701</enddate><creator>Cucinotta, Francescopaolo</creator><creator>Swinnen, Bart</creator><creator>Makovac, Elena</creator><creator>Hirschbichler, Stephanie</creator><creator>Pereira, Erlick</creator><creator>Little, Simon</creator><creator>Morgante, Francesca</creator><creator>Ricciardi, Lucia</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-9401-3301</orcidid></search><sort><creationdate>20240701</creationdate><title>Short term cardiovascular symptoms improvement after deep brain stimulation in patients with Parkinson's disease: a systematic review</title><author>Cucinotta, Francescopaolo ; Swinnen, Bart ; Makovac, Elena ; Hirschbichler, Stephanie ; Pereira, Erlick ; Little, Simon ; Morgante, Francesca ; Ricciardi, Lucia</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-1c7fc6351bc1b3135febde7398011a90018f3f4befab8903bae0b97cc1d57e253</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Blood pressure</topic><topic>Blood Pressure - physiology</topic><topic>Cardiovascular Diseases - etiology</topic><topic>Cardiovascular Diseases - physiopathology</topic><topic>Cardiovascular Diseases - therapy</topic><topic>Cardiovascular system</topic><topic>Deep brain stimulation</topic><topic>Deep Brain Stimulation - methods</topic><topic>Dopamine receptors</topic><topic>Globus pallidus</topic><topic>Heart rate</topic><topic>Humans</topic><topic>Hypotension</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Movement disorders</topic><topic>Neurodegenerative diseases</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosciences</topic><topic>Parkinson Disease - complications</topic><topic>Parkinson Disease - physiopathology</topic><topic>Parkinson Disease - therapy</topic><topic>Parkinson's disease</topic><topic>Pedunculopontine tegmental nucleus</topic><topic>Review</topic><topic>Subthalamic nucleus</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cucinotta, Francescopaolo</creatorcontrib><creatorcontrib>Swinnen, Bart</creatorcontrib><creatorcontrib>Makovac, Elena</creatorcontrib><creatorcontrib>Hirschbichler, Stephanie</creatorcontrib><creatorcontrib>Pereira, Erlick</creatorcontrib><creatorcontrib>Little, Simon</creatorcontrib><creatorcontrib>Morgante, Francesca</creatorcontrib><creatorcontrib>Ricciardi, Lucia</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cucinotta, Francescopaolo</au><au>Swinnen, Bart</au><au>Makovac, Elena</au><au>Hirschbichler, Stephanie</au><au>Pereira, Erlick</au><au>Little, Simon</au><au>Morgante, Francesca</au><au>Ricciardi, Lucia</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Short term cardiovascular symptoms improvement after deep brain stimulation in patients with Parkinson's disease: a systematic review</atitle><jtitle>Journal of neurology</jtitle><stitle>J Neurol</stitle><addtitle>J Neurol</addtitle><date>2024-07-01</date><risdate>2024</risdate><volume>271</volume><issue>7</issue><spage>3764</spage><epage>3776</epage><pages>3764-3776</pages><issn>0340-5354</issn><issn>1432-1459</issn><eissn>1432-1459</eissn><abstract>Background
Autonomic dysfunction is common and disabling in Parkinson's disease (PD). The effects of deep brain stimulation (DBS) on the cardiovascular system in PD remain poorly understood. We aimed to assess the effect of DBS on cardiovascular symptoms and objective measures in PD patients.
Methods
We conducted a systematic literature search in PubMed/MEDLINE.
Results
36 out of 472 studies were included, mostly involving DBS of the subthalamic nucleus, and to a lesser extent the globus pallidus pars interna and pedunculopontine nucleus. Seventeen studies evaluated the effect of DBS on patient-reported or clinician-rated cardiovascular symptoms, showing an improvement in the first year after surgery but not with longer-term follow-up. DBS has no clear direct effects on blood pressure during an orthostatic challenge (n = 10 studies). DBS has inconsistent effects on heart rate variability (n = 10 studies).
Conclusion
Current evidence on the impact of DBS on cardiovascular functions in PD is inconclusive. DBS may offer short-term improvement of cardiovascular symptoms in PD, particularly orthostatic hypotension, which may be attributed to dopaminergic medication reduction after surgery. There is insufficient evidence to draw conclusions on the direct effect of DBS on blood pressure and heart rate variability.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>38809271</pmid><doi>10.1007/s00415-024-12459-1</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0001-9401-3301</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of neurology, 2024-07, Vol.271 (7), p.3764-3776 |
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| subjects | Blood pressure Blood Pressure - physiology Cardiovascular Diseases - etiology Cardiovascular Diseases - physiopathology Cardiovascular Diseases - therapy Cardiovascular system Deep brain stimulation Deep Brain Stimulation - methods Dopamine receptors Globus pallidus Heart rate Humans Hypotension Medicine Medicine & Public Health Movement disorders Neurodegenerative diseases Neurology Neuroradiology Neurosciences Parkinson Disease - complications Parkinson Disease - physiopathology Parkinson Disease - therapy Parkinson's disease Pedunculopontine tegmental nucleus Review Subthalamic nucleus Surgery |
| title | Short term cardiovascular symptoms improvement after deep brain stimulation in patients with Parkinson's disease: a systematic review |
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