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Deep brain stimulation amplitude alters posture shift velocity in Parkinson’s disease

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Abstract

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is now widely used to alleviate symptoms of Parkinson’s disease (PD). The specific aim of this study was to identify posture control measures that may be used to improve selection of DBS parameters in the clinic and this was carried out by changing the DBS stimulation amplitude. A dynamic posture shift paradigm was used to assess posture control in 4 PD STN-DBS subjects. Each subject was tested at 4 stimulation amplitude settings. Movements of the center of pressure and the position of the pelvis were monitored and several quantitative indices were calculated. The presence of any statistically significant changes in several normalized indices due to reduced/no stimulation was tested using the one-sample t test. The peak velocity and the average movement velocity during the initial and mid phases of movement towards the target posture were substantially reduced. These results may be explained in terms of increased akinesia and bradykinesia due to altered stimulation conditions. Thus, the dynamic posture shift paradigm may be an effective tool to quantitatively characterize the effects of DBS on posture control and should be further investigated as a tool for selection of DBS parameters in the clinic.

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Abbreviations

AR:

Akinetic-rigidity

C:

Center

CD:

Clinically-determined

CDL :

Clinically-determined setting on the day low amplitude was tested

CDM :

Clinically-determined setting on the day moderate amplitude was tested

CDO :

Clinically-determined setting on the day off stimulation was tested

COP:

Center of pressure

DBS:

Deep brain stimulation

E:

East

E H :

Error during holding phase

FOG:

Freezing of gait

H&Y:

Hoehn & Yahr

Hz:

Hertz

LOS:

Limits of stability

LOW:

Low

MOD:

Moderate

MX:

Mixed symptoms

N:

North

NE:

North East

NW:

North West

OFF:

Off

PD:

Parkinson’s disease

PLI :

Pathlength of initiation phase

PL M :

Pathlength of movement phase

POP:

Position of pelvis

STN:

Subthalamic nucleus

T:

Tremor

T I :

Time of initiation phase

T M :

Time of movement phase

U H :

Unsteadiness of holding phase

UPDRS:

Unified Parkinson’s Disease Rating Scale

V I :

Velocity of initiation phase

V M :

Velocity of movement phase

V P :

Peak velocity

W:

West

References

  • Bartolic A, Pirtosek Z, Rozman J et al (2005) Postural stability of Parkinson’s disease patients is improved by decreasing rigidity. Eur J Neurol 12(2):156–159

    Article  PubMed  CAS  Google Scholar 

  • Bejjani BP, Gervais D, Arnulf I et al (2000) Axial parkinsonian symptoms can be improved: the role of levodopa and bilateral subthalamic stimulation. J Neurol Neurosurg Psychiatry 68(5):595–600

    Article  PubMed  CAS  Google Scholar 

  • Benabid AL, Pollak P, Gervason C et al (1991) Long-term suppression of tremor by chronic stimulation of the ventral intermediate thalamic nucleus. Lancet 337(8738):403–406

    Article  PubMed  CAS  Google Scholar 

  • Benabid AL, Koudsie A, Benazzouz A et al (2000) Subthalamic stimulation for Parkinson’s disease. Arch Med Res 31(3):282–289

    Article  PubMed  CAS  Google Scholar 

  • Bloem BR, Beckley DJ, van Hilten BJ et al (1998) Clinimetrics of postural instability in Parkinson’s disease. J Neurol 245(10):669–673

    Article  PubMed  CAS  Google Scholar 

  • Bloem BR, van Vugt JP, Beckley DJ (2001) Postural instability and falls in Parkinson’s disease. Adv Neurol 87:209–223

    PubMed  CAS  Google Scholar 

  • Colnat-Coulbois S, Gauchard GC, Maillard L et al (2005) Bilateral subthalamic nucleus stimulation improves balance control in Parkinson’s disease. J Neurol Neurosurg Psychiatry 76(6):780–787

    Article  PubMed  CAS  Google Scholar 

  • Gross RE, Lozano AM (2000) Advances in neurostimulation for movement disorders. Neurol Res 22(3):247–258

    PubMed  CAS  Google Scholar 

  • Guehl D, Dehail P, de Seze MP et al (2006) Evolution of postural stability after subthalamic nucleus stimulation in Parkinson’s disease: a combined clinical and posturometric study. Exp Brain Res 170(2):206–215

    Article  PubMed  CAS  Google Scholar 

  • Hamman RG, Mekjavic I, Mallinson AI et al (1992) Training effects during repeated therapy sessions of balance training using visual feedback. Arch Phys Med Rehabil 73(8):738–744

    PubMed  CAS  Google Scholar 

  • Horak FB, Nutt JG, Nashner LM (1992) Postural inflexibility in parkinsonian subjects. J Neurol Sci 111(1):46–58

    Article  PubMed  CAS  Google Scholar 

  • Kumru H, Summerfield C, Valldeoriola F et al (2003) Effects of subthalamic nucleus stimulation on characteristics of EMG activity underlying reaction time in Parkinson’s disease. Mov Disord 19(1):94–100

    Article  Google Scholar 

  • Kuncel AM, Grill WM (2004) Selection of stimulus parameters for deep brain stimulation. Clin Neurophysiol 115(11):2431–2441

    Article  PubMed  Google Scholar 

  • Kuncel AM, Cooper SE, Wolgamuth BR et al (2006) Clinical response to varying the stimulus parameters in deep brain stimulation for essential tremor. Mov Disord 21(11):1920–1928

    Article  PubMed  Google Scholar 

  • Lakke JP (1985) Axial apraxia in Parkinson’s disease. J Neurol Sci 69(1–2):37–46

    Article  PubMed  CAS  Google Scholar 

  • Lakke JP, van Weerden TW, Staal-Schreinemachers A (1984) Axial apraxia, a distinct phenomenon. Clin Neurol Neurosurg 86(4):291–294

    Article  PubMed  CAS  Google Scholar 

  • Maurer C, Mergner T, Xie J et al (2003) Effect of chronic bilateral subthalamic nucleus (STN) stimulation on postural control in Parkinson’s disease. Brain 126(Pt 5):1146–1163

    Article  PubMed  CAS  Google Scholar 

  • Moro E, Esselink RJ, Xie J et al (2002) The impact on Parkinson’s disease of electrical parameter settings in STN stimulation. Neurology 59(5):706–713

    Article  PubMed  CAS  Google Scholar 

  • Nilsson MH, Tornqvist AL, Rehncrona S (2005) Deep-brain stimulation in the subthalamic nuclei improves balance performance in patients with Parkinson’s disease, when tested without anti-parkinsonian medication. Acta Neurol Scand 111(5):301–308

    Article  PubMed  CAS  Google Scholar 

  • Rocchi L, Chiari L, Horak FB (2002) Effects of deep brain stimulation and levodopa on postural sway in Parkinson’s disease. J Neurol Neurosurg Psychiatry 73(3):267–274

    Article  PubMed  CAS  Google Scholar 

  • Samson RD, Frank MJ, Fellous JM (2010) Computational models of reinforcement learning: the role of dopamine as a reward signal. Cogn Neurodyn 4(2):91–105

    Article  PubMed  CAS  Google Scholar 

  • Stack E, Ashburn A (1999) Fall events described by people with Parkinson’s disease: implications for clinical interviewing and the research agenda. Physiother Res Int 4(3):190–200

    Article  PubMed  CAS  Google Scholar 

  • Stack E, Ashburn A, Jupp K (2005) Postural instability during reaching tasks in Parkinson’s disease. Physiother Res Int 10(3):146–153

    Article  PubMed  Google Scholar 

  • Temperli P, Ghika J, Villemure JG et al (2003) How do parkinsonian signs return after discontinuation of subthalamic DBS? Neurology 60(1):78–81

    Article  PubMed  CAS  Google Scholar 

  • Vaillancourt DE, Prodoehl J, Verhagen Metman L et al (2004) Effects of deep brain stimulation and medication on bradykinesia and muscle activation in Parkinson’s disease. Brain 127(Pt 3):491–504

    PubMed  Google Scholar 

  • Vaillancourt DE, Prodoehl J, Sturman MM et al (2006) Effects of deep brain stimulation and medication on strength, bradykinesia, and electromyographic patterns of the ankle joint in Parkinson’s disease. Mov Disord 21(1):50–58

    Article  PubMed  Google Scholar 

  • Vrancken AM, Allum JH, Peller M et al (2005) Effect of bilateral subthalamic nucleus stimulation on balance and finger control in Parkinson’s disease. J Neurol 252(12):1487–1494

    Article  PubMed  CAS  Google Scholar 

  • Wang L (2007) Interactions between neural networks: a mechanism for tuning chaos and oscillations. Cogn Neurodyn 1(2):185–188

    Article  PubMed  Google Scholar 

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Acknowledgments

We acknowledge support for this study from Arizona State University (Tempe, AZ) and Banner Good Samaritan Medical Center (Phoenix, AZ).

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Author notes

  1. Narayanan Krishnamurthi

    Present address: Muhammad Ali Parkinson Center, Barrow Neurological Institute, 240 W. Thomas Road, Ste. 301, Phoenix, AZ, 85013, USA

Authors and Affiliations

  1. Center for Adaptive Neural Systems, School of Biological and Health Systems Engineering, Arizona State University, 1100 East University Drive, Suite 116, Tempe, AZ, 85281, USA

    Narayanan Krishnamurthi, Stefani Mulligan, Padma Mahant, Johan Samanta & James J. Abbas

  2. Movement Disorders Clinic, Banner Good Samaritan Medical Center, Phoenix, AZ, 85006, USA

    Padma Mahant & Johan Samanta

Authors
  1. Narayanan Krishnamurthi
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  2. Stefani Mulligan
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  3. Padma Mahant
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  4. Johan Samanta
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  5. James J. Abbas
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Correspondence to Narayanan Krishnamurthi.

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Krishnamurthi, N., Mulligan, S., Mahant, P. et al. Deep brain stimulation amplitude alters posture shift velocity in Parkinson’s disease. Cogn Neurodyn 6, 325–332 (2012). https://doi.org/10.1007/s11571-012-9201-5

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  • DOI: https://doi.org/10.1007/s11571-012-9201-5

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