Subthalamic deep brain stimulation does not impact on cardiovascular and sudomotor functions assessed by head-up tilt test and sudoscan.

Aim of this study is to assess the effects of subthalamic deep brain stimulation (STN-DBS) on cardiovascular and sudomotor autonomic functions in Parkinson’s disease (PD) patients. Ten subjects with advanced PD and bilateral STN-DBS underwent head-up tilt test (HUTT) and electrochemical skin conductance (ESC) measured with Sudoscan, under three conditions: DBS ON and therapy OFF (DBS ON/Th OFF), 30 min after switching off the DBS (DBS OFF/Th OFF), and 30 min after switching on the DBS and administering melevodopa/carbidopa 100/25 mg (DBS ON/Th ON). A significant reduction in systolic blood pressure at the 10th minute of HUTT in the DBS ON/Th ON condition was detected, compared to the DBS OFF/Th OFF condition (p 0.036). No other significant differences were observed in heart rate (HR), blood pressure (BP) and electro-chemical skin conductance among the three conditions. STN-DBS does not influence cardiovascular and sudomotor autonomic regulation, however, it may exert a positive effect on cardiovascular reactivity by an indirect mechanism, as it decreases levodopa load.