Investigating the neural correlates of subjective sleep changes following subthalamic nucleus deep brain stimulation for Parkinson's disease

Andrews, Luke, Keller, Simon S ORCID: 0000-0001-5247-9795, Bhojak, Maneesh, Osman-Farah, Jibril and Macerollo, Antonella ORCID: 0000-0003-4322-2706 (2025) Investigating the neural correlates of subjective sleep changes following subthalamic nucleus deep brain stimulation for Parkinson's disease PARKINSONISM & RELATED DISORDERS, 136. 107887-. ISSN 1353-8020, 1873-5126

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Abstract

Introduction: Sleep disturbances in Parkinson's disease (PD) are extremely common and significantly impact quality of life. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an established therapy for motor symptoms and may also influence sleep outcomes. However, the relationship between stimulation location, structural networks, and sleep improvements remains poorly understood, particularly over longer durations. Methods: We conducted a retrospective analysis of 53 PD patients implanted with bilateral STN-DBS. Sleep outcomes were assessed using self-report measures, with subsection scores for nighttime sleep, daytime wakefulness, and total sleep disturbance analysed. Local stimulation effects were modelled using sweet spot analyses, and innervated tracts were examined through discriminative fiber filtering. Associations with motor improvements and demographic factors were analysed. Results: Significant improvements were reported in both nighttime sleep and daytime wakefulness. Motor symptom improvements were significantly positively associated with cumulative sleep scores but did not fully explain sleep changes. Sweet spot analyses revealed associations between cumulative sleep score improvements and the sensorimotor STN, while fiber filtering implicated brainstem, cerebellar, and cortical motor tracts for daytime and cumulative sleep improvements. These associations remained significant after controlling for motor improvements. Discussion: Our findings suggest that STN-DBS may modulate sleep via broader structural connections and beyond motor symptom improvements. The lateralised effects and involvement of widespread tracts underscore the complexity of DBS-related sleep modulation. Future studies should incorporate longitudinal designs and objective measures to disentangle motor-independent mechanisms and optimise therapeutic strategies.

Item Type:	Article
Uncontrolled Keywords:	Subthalamic Nucleus, Humans, Parkinson Disease, Deep Brain Stimulation, Retrospective Studies, Aged, Middle Aged, Female, Male, Sleep Wake Disorders
Divisions:	Faculty of Health & Life Sciences Faculty of Health & Life Sciences > Inst. Systems, Molec & Integrative Biology > Inst. Systems, Molec & Integrative Biology
Depositing User:	Symplectic Admin
Date Deposited:	02 Jun 2025 08:28
Last Modified:	16 Jun 2026 20:03
DOI:	10.1016/j.parkreldis.2025.107887
Open Access URL:	https://www.prd-journal.com/article/S1353-8020(25)...
Related Websites:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3192905
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