Subthalamic deep brain stimulation improves vascular endothelial function in Parkinson's disease

Objectives: Vascular health (white matter change, vascular risk factor, angiogenesis, microvascular alteration) is associated with clinical progression or levodopa-induced dyskinesia in PD. Vascular endothelial function is known to reflect the earliest vascular change. While DBS can improve motor and non-motor symptoms, the effect of DBS on vascular endothelial function is unknown. Thus, we aimed to investigate whether DBS surgery could impact vascular endothelial function in PD.Method: A total of 20 PD patients were recruited. Vascular endothelial function was evaluated with flowmediated dilation (FMD). FMD was investigated before and after one year of DBS surgery.Results: FMD improved (6.01 +/- 1.58 to 6.84 +/- 1.57, p = 0.027). While the level of homocysteine slightly decreased (13.8 +/- 4.1 to 13.0 +/- 3.2, p = 0.05), there was no significant correlation between FMD changes and homocysteine levels (r = 0.42, p = 0.065). FMD change was associated with baseline age (r = -0.59, p = 0.006) but not with disease duration (p = 0.73), baseline UPDRS III (p = 0.81), change of UPDRS III and dyskinesia, and LEDD change (p = 0.94). Multivariate linear regression analysis revealed that only age (B = -0.139; p = 0.024) was significantly and inversely correlated with the change of FMD.Conclusions: We found that STN-DBS improves vascular endothelial function in PD. Further studies are needed to clarify the exact pathogenesis and clinical implication of beneficial effects on vascular endothelial dysfunction in PD.