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Orthostatic hypotension following deep brain stimulation in parkinson's disease: a systematic review.
Br J Neurosurg 2019; :1-4BJ

Abstract

Background:

Deep brain stimulation (DBS) is a treatment that may be suitable for patients with Parkinson's disease (PD) with severe motor fluctuations and/or dyskinesias despite optimised medical therapy. DBS has been associated with side effects including deterioration in cognition, verbal fluency and mood. Studies assessing the effect of DBS on orthostatic hypotension (OH) have produced variable results.

Objectives:

The aim is to summarise peer-reviewed studies that have assessed the effect of DBS on systolic or diastolic BP in PD patients.

Methods:

The databases PubMed, EMBASE, Medline and Scopus were searched using the terms (Deep brain stimulation OR DBS) AND (hypotension OR hypertension OR blood pressure) on 13 April 2017.

Results:

Fourteen studies fulfilled the inclusion criteria. Ten studies involved subthalamic nucleus (STN) DBS, three studies globus pallidus interna (GPi) DBS and one study involved DBS of the pedunculopontine nuclei and motor thalamus. The majority of the studies found results indicating that DBS in PD does not worsen OH in PD.

Conclusions:

Small sample sizes and lack of blinding of outcome assessors means this result should be approached cautiously. Future research may further investigate the effect of GPi DBS on OH and should aim to address these methodological issues.

Authors+Show Affiliations

a Adelaide Medical School , University of Adelaide , Adelaide , Australia.b The Queen Elizabeth Hospital , Woodville , Australia.c Department of Neurosurgery , Royal Adelaide Hospital , Adelaide , Australia.c Department of Neurosurgery , Royal Adelaide Hospital , Adelaide , Australia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31294612

Citation

Bunjo, Zachary, et al. "Orthostatic Hypotension Following Deep Brain Stimulation in Parkinson's Disease: a Systematic Review." British Journal of Neurosurgery, 2019, pp. 1-4.
Bunjo Z, Bacchi S, Chandran AS, et al. Orthostatic hypotension following deep brain stimulation in parkinson's disease: a systematic review. Br J Neurosurg. 2019.
Bunjo, Z., Bacchi, S., Chandran, A. S., & Zacest, A. (2019). Orthostatic hypotension following deep brain stimulation in parkinson's disease: a systematic review. British Journal of Neurosurgery, pp. 1-4. doi:10.1080/02688697.2019.1639617.
Bunjo Z, et al. Orthostatic Hypotension Following Deep Brain Stimulation in Parkinson's Disease: a Systematic Review. Br J Neurosurg. 2019 Jul 11;1-4. PubMed PMID: 31294612.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Orthostatic hypotension following deep brain stimulation in parkinson's disease: a systematic review. AU - Bunjo,Zachary, AU - Bacchi,Stephen, AU - Chandran,Arjun S, AU - Zacest,Andrew, Y1 - 2019/07/11/ PY - 2019/7/12/entrez KW - Parkinson’s disease KW - deep brain stimulation KW - orthostatic hypotension KW - postural hypotension SP - 1 EP - 4 JF - British journal of neurosurgery JO - Br J Neurosurg N2 - Background: Deep brain stimulation (DBS) is a treatment that may be suitable for patients with Parkinson's disease (PD) with severe motor fluctuations and/or dyskinesias despite optimised medical therapy. DBS has been associated with side effects including deterioration in cognition, verbal fluency and mood. Studies assessing the effect of DBS on orthostatic hypotension (OH) have produced variable results. Objectives: The aim is to summarise peer-reviewed studies that have assessed the effect of DBS on systolic or diastolic BP in PD patients. Methods: The databases PubMed, EMBASE, Medline and Scopus were searched using the terms (Deep brain stimulation OR DBS) AND (hypotension OR hypertension OR blood pressure) on 13 April 2017. Results: Fourteen studies fulfilled the inclusion criteria. Ten studies involved subthalamic nucleus (STN) DBS, three studies globus pallidus interna (GPi) DBS and one study involved DBS of the pedunculopontine nuclei and motor thalamus. The majority of the studies found results indicating that DBS in PD does not worsen OH in PD. Conclusions: Small sample sizes and lack of blinding of outcome assessors means this result should be approached cautiously. Future research may further investigate the effect of GPi DBS on OH and should aim to address these methodological issues. SN - 1360-046X UR - https://www.unboundmedicine.com/medline/citation/31294612/Orthostatic_hypotension_following_deep_brain_stimulation_in_parkinson's_disease:_a_systematic_review L2 - http://www.tandfonline.com/doi/full/10.1080/02688697.2019.1639617 DB - PRIME DP - Unbound Medicine ER -