Orthostatic hypotension following deep brain stimulation in parkinson’s disease: a systematic review.

Orthostatic hypotension following deep brain stimulation in parkinson’s disease: a systematic review.

Publication date: Jul 11, 2019

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.

Bunjo, Z., Bacchi, S., Chandran, A.S., and Zacest, A. Orthostatic hypotension following deep brain stimulation in parkinson’s disease: a systematic review. 21547. 2019 Br J Neurosurg.

Concepts Keywords
Blood Pressure Orthostatic hypotension
Cognition Disease
DBS Deep brain stimulation
Deep Brain Stimulation Medicine
Diastolic Clinical medicine
Dyskinesias Medical specialties
EMBASE Vascular diseases
Globus Pallidus Neurotechnology
Hypertension Neurosurgical procedures
Hypotension Electrotherapy
Medline Parkinson’s disease
Nuclei Deep brain stimulation
Orthostatic Hypotension Orthostatic hypotension
Parkinson Subthalamic nucleus
PubMed
Scopus
Subthalamic Nucleus
Systematic Review
Systolic
Thalamus

Semantics

Type Source Name
gene UNIPROT GNPDA1
gene UNIPROT GPI
gene UNIPROT EEF1A2
drug DRUGBANK Pentaerythritol tetranitrate
gene UNIPROT TNFSF13
gene UNIPROT ANP32B
disease DOID hypertension
disease MESH hypertension
disease MESH hypotension
gene UNIPROT DNMT1
gene UNIPROT CD69
gene UNIPROT CD5L
disease MESH dyskinesias
gene UNIPROT LRP2
gene UNIPROT MCF2L
disease MESH Orthostatic hypotension

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