Subthalamic stimulation modulates cortical control of urinary bladder in Parkinson's disease

Brain. 2006 Dec;129(Pt 12):3366-75. doi: 10.1093/brain/awl302. Epub 2006 Oct 31.


Subthalamic nucleus deep brain stimulation (STN-DBS) is an effective therapy for off-period motor symptoms and dyskinesias in advanced Parkinson's disease. Clinical studies have shown that STN-DBS also ameliorates urinary bladder function in Parkinson's disease patients by delaying the first desire to void and increasing bladder capacity. This study aimed at investigating the effect of STN-DBS on the neural mechanisms underlying cerebral bladder control. Using PET to measure changes in regional cerebral blood flow (rCBF), 11 patients with bilateral STN-DBS were studied during urodynamic bladder filling in STN-DBS ON and OFF condition. A filled bladder led to a significant increase of rCBF in the anterior cingulate cortex, which was further enhanced during STN-DBS OFF. A significant interaction between bladder state and STN-DBS was observed in lateral frontal cortex with increased rCBF when the bladder was filled during STN-DBS OFF. The data suggest that STN-DBS ameliorates bladder dysfunction and that this modulation may result from facilitated processing of afferent bladder information.

Publication types

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

MeSH terms

  • Adult
  • Aged
  • Antiparkinson Agents / therapeutic use
  • Basal Ganglia / physiopathology
  • Cerebral Cortex / physiopathology*
  • Cerebrovascular Circulation / physiology
  • Deep Brain Stimulation / methods*
  • Female
  • Frontal Lobe / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Parkinson Disease / drug therapy
  • Parkinson Disease / physiopathology
  • Parkinson Disease / therapy*
  • Positron-Emission Tomography / methods
  • Subthalamic Nucleus / physiopathology*
  • Urinary Bladder / physiopathology*
  • Urination / physiology
  • Urodynamics / physiology


  • Antiparkinson Agents