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.
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
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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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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