A comparison of indirect and direct targeted STN DBS in the treatment of Parkinson's disease-surgical method and clinical outcome over 15-year timespan.

Background: Deep brain stimulation (DBS) in the subthalamic nucleus (STN) is used in advanced Parkinson's disease (PD) for reducing motor fluctuations and the side effects of antiparkinsonian medication (APM). The development of neuroimaging has enabled the direct targeting of the STN. The aim of this study is to evaluate the outcome in patients with PD using STN DBS when changing from atlas-based indirect targeting method (iTM) to direct MRI-based targeting (dTM) assuming dTM is superior.

Sweating in Parkinsonian patients with wearing-off.

Disorders of the autonomic nervous system are common in Parkinson's disease (PD). Earlier studies suggest that some nonmotor symptoms may fluctuate with the motor symptoms, but the possible interrelationship between motor phenomena and sweating has not been studied. The authors measured sweating by using an evaporimeter on three different areas of the body (right hand, left hand, chest) immediately before the morning PD medication (baseline), and thereafter hourly up to 4 hour, in 16 PD patients with wearing-off type of motor fluctuations and in 15 patients without clinical motor fluctuations.

Circadian heart rate variability in Parkinson's disease.

Parkinson's disease is known to affect the reflex cardiovascular control systems, resulting in a suppressed heart rate variability, but present knowledge concerning the long-term characteristics of heart rate and heart rate variability, e. g. circadian regulation, is limited.