Sleep difficulties affect up to 98% of Parkinson’s disease (PD) patients and are often not well treated. How globus pallidus internus (GPi)-DBS could help is less understood. We retrospectively analyzed sleep outcomes in 32 PD patients after GPi-DBS with a two-year follow-up. We observed high heterogeneity in sleep response to pallidal stimulation: 16 patients showed clinically meaningful improvement, 9 had minor changes, and 7 experienced worsened sleep quality, with no overall significant change on the Parkinson’s Disease Sleep Scale-2 (P = 0.19). Further analysis revealed that stimulation of the left sensorimotor GPi was significantly associated with sleep improvement. Fiber tracts from the left sensorimotor GPi to the bilateral sensorimotor cortex, right GPi, brainstem, and bilateral cerebellum were linked to better sleep, while projections to the left hippocampus correlated with worsened sleep. These findings may guide personalized GPi-DBS lead placement to optimize sleep outcomes in PD.

睡眠困难影响了高达 98% 的帕金森病 （PD） 患者，并且通常没有得到很好的治疗。苍白球内侧 （GPi）-DBS 如何提供帮助尚不清楚。我们回顾性分析了 32 例 PD 患者在 GPi-DBS 后进行的睡眠结局，并进行了两年的随访。我们观察到睡眠对苍白球刺激的反应具有高度异质性：16 名患者表现出具有临床意义的改善，9 名患者有轻微变化，7 名睡眠质量恶化，帕金森病睡眠量表 2 总体上没有显着变化 （P = 0.19）。进一步分析显示，刺激左侧感觉运动 GPi 与睡眠改善显著相关。从左侧感觉运动 GPi 到双侧感觉运动皮层、右侧 GPi、脑干和双侧小脑的纤维束与更好的睡眠有关，而向左侧海马体的投射与睡眠恶化相关。这些发现可能指导个性化的 GPi-DBS 导联放置，以优化 PD 的睡眠结局。