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Respir Physiol Neurobiol. 2014 Feb 1;192:128-33. doi: 10.1016/j.resp.2013.12.014. Epub 2013 Dec 26.

Dyspnea as a side effect of subthalamic nucleus deep brain stimulation for Parkinson's disease.

Author information

1
Nuffield Department of Surgical Sciences and Department of Neurosurgery University of Oxford, Level 3, West Wing, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK; MD-PhD Program, College of Physicians & Surgeons, Columbia University, 630 West 168th Street, P&S 11-511, New York, NY 10032, USA. Electronic address: jc3304@columbia.edu.
2
Nuffield Department of Surgical Sciences and Department of Neurosurgery University of Oxford, Level 3, West Wing, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK. Electronic address: Holly.Sitsapesan@orh.nhs.uk.
3
Nuffield Department of Clinical Neurosciences and FMRIB Centre University of Oxford, Level 6, West Wing, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK. Electronic address: kyle.pattinson@ndcn.ox.ac.uk.
4
Nuffield Department of Clinical Neurosciences and FMRIB Centre University of Oxford, Level 6, West Wing, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK. Electronic address: mari.herigstad@ndcn.ox.ac.uk.
5
Nuffield Department of Surgical Sciences and Department of Neurosurgery University of Oxford, Level 3, West Wing, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK. Electronic address: tipu.aziz@nds.ox.ac.uk.
6
Nuffield Department of Surgical Sciences and Department of Neurosurgery University of Oxford, Level 3, West Wing, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK. Electronic address: alex.green@nds.ox.ac.uk.

Abstract

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 Unpublished observations from our clinic noted that some subthalamic nucleus deep brain stimulation patients complain of post-operative dyspnea.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.

KEYWORDS:

Breathlessness; Deep brain stimulation; Dyspnea; Parkinson's disease; Subthalamic nucleus

PMID:
24373841
DOI:
10.1016/j.resp.2013.12.014
[Indexed for MEDLINE]

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