Patients referred to neurosurgery routinely and safely undergo deep brain stimulation (DBS) for treatment of symptoms related to neurodegenerative conditions, most commonly Parkinson's disease. In the investigators experience, and published evidence shows, that stimulation has effects on the autonomic nervous system. In patients undergoing therapeutic DBS for a particular subtype of Parkinsonism, Multiple System Atrophy, the further effects on autonomic parameters such as blood pressure and bladder symptoms as well as the originally intended indications (gait and movement disorder) will be investigated. The mechanisms of any effects will also be studied by using a number of techniques such as magnetoencephalography (MEG) and Muscle Sympathetic Nerve Activity (MSNA) recording. Key goals are to: 1. Demonstrate that stimulation of the peduculopontine nucleus (PPN) improves autonomic function and has an attendant improvement on patients' quality of life 2. Investigate the role of the PPN and how it interacts with other brain areas. This translational strategy will lead to a larger efficacy study of DBS for MSA as well as revolutionizing neural-based treatments in other autonomic disorders such as orthostatic hypotension and pure autonomic failure.
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EuroQol 5 Dimension (5 level) score before and after deep brain stimulation
Timeframe: Through study completion, but on average, over an 8 month period for each patient
Fluency of gait as measured by accelerometry before and after deep brain stimulation
Timeframe: Through study completion, but on average, over an 8 month period for each patient
Modified composite autonomic symptom scale before and after deep brains stimulation
Timeframe: Through study completion, but on average, over an 8 month period for each patient
Change in postural blood pressure change before and after PPN DBS
Timeframe: Through study completion, but on average, over an 8 month period for each patient