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The autonomic nervous system is important in cardiovascular regulation. The peripheral autonomic nervous system is at least in part accessible to direct measurements. However, it is difficult to assess central autonomic nervous system function in humans and the role of CNS pathways in human autonomic regulation is poorly understood. In recent years, deep brain stimulation (DBS) of the basal ganglia has been used to alleviate motor symptoms in advanced Parkinson disease (PD) and other movement disorders. Although the impact of DBS on motor function is well described, little is known about DBS effects on nonmotor structures within the central components of the autonomic nervous system. Furthermore, DBS provides a unique opportunity to map autonomic pathways close to the stimulation site.
We studied five patients (three men, two women, aged 61 ± 7 years; see table E-1 on the Neurology Web site at www.neurology.org) treated bilaterally with a subthalamic nucleus (STN) stimulator for an advanced Parkinson syndrome. The deep brain stimulator leads were equipped with four separated electrodes (1.5-mm wide, 0.5-mm space in between). We continuously measured heart rate (electrocardiogram), respiration (thoracic bioimpedance) and blood …
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