Influence of deep brain stimulation and levodopa on sensory signs in Parkinson's disease

Mov Disord. 2010 Jul 15;25(9):1195-202. doi: 10.1002/mds.23128.

Abstract

To examine the effects of levodopa (L-dopa) and deep brain stimulation of the subthalamic nucleus (STN-DBS) on sensory symptoms and signs in Parkinson's disease (PD). Seventeen patients with PD were included. (1) Presence of sensory symptoms and (2) effects of L-dopa and STN-DBS on sensory symptoms and signs [assessed by quantitative sensory testing (QST)] were examined 6 months after starting STN-DBS. In addition, in 12 of these patients, presence of sensory symptoms prior and post STN-DBS was compared. Pain was most frequently nociceptive. In about 30-40%, pain and sensory symptoms were associated with PD motor symptoms. In most of these cases, pain responded to L-dopa. Intensity of pain was reduced post STN-DBS compared to pre STN-DBS. L-Dopa had no influence on detection thresholds, whereas STN-DBS improved thermal detection thresholds. However, thermal and mechanical pain thresholds were uninfluenced by L-dopa or STN-DBS. Although some patients reported an improvement of pain with STN-DBS or L-dopa, objectively pain sensitivity as assessed by QST was not altered by STN-DBS or L-dopa suggesting that there is no evidence for a direct modulation of central pain processing by L-dopa or STN-DBS.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antiparkinson Agents / therapeutic use*
  • Deep Brain Stimulation / methods*
  • Female
  • Humans
  • Levodopa / therapeutic use*
  • Male
  • Middle Aged
  • Pain Measurement / methods
  • Parkinson Disease / complications
  • Parkinson Disease / therapy
  • Sensation Disorders / etiology
  • Sensation Disorders / therapy*
  • Sensory Thresholds / drug effects
  • Sensory Thresholds / physiology
  • Statistics, Nonparametric
  • Subthalamic Nucleus / physiology
  • Surveys and Questionnaires

Substances

  • Antiparkinson Agents
  • Levodopa