Objective: The aim of this study was to determine if there is an improvement in rapid eye movement (REM) sleep behavior disorder (RBD) for patients with Parkinson’s disease (PD) one year after the insertion of deep brain stimulation (DBS) at globus pallidus interna (GPi).

Background: RBD is a parasomnia that leads to a loss of REM atonia during sleep. Patients may demonstrate a wide array of behaviors while enacting dreams. Parkinson’s disease is the second most common neurodegenerative disorder characterized by both motor and nonmotor symptoms including sleep disorders such as RBD. RBD may precede the onset of motor symptoms in PD by many years and has a prevalence of about 50% among patients with PD. DBS is an effective surgical treatment for patients with PD experiencing motor fluctuation. However, little is known about its impact on various sleep disorders. A handful of studies have evaluated the outcomes of RBD following subthalamic nucleus DBS in PD, but little is known about the impact of GPi DBS on RBD.

Method: Patients with PD undergoing GPi DBS were surveyed at baseline and 12 months after DBS using the REM Sleep Behavior Disorder Screening Questionnaire (RBDSQ) to determine the presence of RBD (RBDSQ ≥ 5) and severity of symptoms. Medication regimens were also collected to assess for possible confounding factors affecting RBD.

Results: Out of 12 patients, 3 met the clinical criteria for RBD at baseline. Patient 1 is 76 years old with a change in RBDSQ from 10 at baseline to 9 at 12 months post-DBS. Patient 2 is 66 years old with a change in RBDSQ from 6 at baseline to 5 at 12 months post-DBS. Patient 3 is 75 years old with a change in RBDSQ from 8 at baseline to 7 at 12 months.

Conclusion: This study suggested that GPi DBS had no impact on RBD for patients with PD. No significant differences were observed in the RBDSQ at baseline versus 12 months among the three patients. This may suggest that GPi has no obvious connections to the circuitry that regulates REM sleep. However, our sample size was limited. Future studies with larger sample sizes are likely required to address this question.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/impact-of-globus-pallidus-interna-deep-brain-stimulation-on-rem-sleep-behavior-disorder-in-parkinsons-disease/