Bilateral subthalamic nucleus deep brain stimulation for Parkinson's disease improves limb function. Unpublished observations from our clinic noted that some subthalamic nucleus deep brain stimulation patients complain of post-operative dyspnea. Therefore, we designed a prospective, longitudinal study to characterize this in greater depth. We used specific questionnaires to assess dyspnea in patients with electrodes in the subthalamic nucleus (n=13) or ventral intermediate thalamus (n=7). St. George's Hospital Respiratory Questionnaire symptom subscale scores were greater in subthalamic nucleus patients (median=18.60, interquartile range=40.80) than ventral intermediate thalamus patients (median = 0.00, interquartile range=15.38) at greater than 6 months post-operatively (p<0.05). Several of the subthalamic nucleus patients exhibited functional impairments as judged by the St. George's Hospital Respiratory Questionnaire impact subscale, the Medical Research Council Dyspnoea Scale, and the Dyspnoea-12 Questionnaire. There was no correlation between limb function ratings, stimulation parameters, or precise electrode position and dyspnea severity. We have shown, for the first time, that dyspnea can be a side effect of subthalamic nucleus deep brain stimulation, and that this dyspnea may be highly disabling.
Journal article
Respir Physiol Neurobiol
01/02/2014
192
128 - 133
Breathlessness, Deep brain stimulation, Dyspnea, Parkinson's disease, Subthalamic nucleus, Affective Symptoms, Aged, Catastrophization, Deep Brain Stimulation, Dyspnea, Fatigue, Female, Functional Laterality, Humans, Male, Middle Aged, Parkinson Disease, Psychiatric Status Rating Scales, Statistics, Nonparametric, Subthalamic Nucleus, Surveys and Questionnaires