Stimulation of the subthalamic nucleus increases heart rate in patients with Parkinson disease

Cardiovascular adjustments during movement are achieved by changes in autonomic outflow modulated by feedback from mechano- and chemoreceptors in contracting skeletal muscle,1 and by a feed forward mechanism originating in locomotor brain areas called central command.2 In cats, electrical stimulation of the globus pallidum pars externa (GPe) and the subthalamic nucleus (STN)3 increases heart and respiratory rates, suggesting that the basal ganglia may be part of the neural substrate of central command. Recently, the introduction of high frequency electrical stimulation of the STN in the treatment of patients with PD provided a unique opportunity to examine whether, in awake nonsedated humans, the basal ganglia modulate cardiorespiratory function. We report the acute cardiovascular and respiratory effects of STN stimulation on three men with advanced PD in whom, 6 months before, electrodes had been implanted into the STN—bilateral in two and unilateral in one (Medtronic; Minneapolis, MN). Patients were age 71, 49, and 67, Hoehn and Yahr stage of 4, …