Dynamic tension EMG to characterize the effects of DBS treatment of advanced Parkinson's disease

Abstract

Deep brain stimulation (DBS) is an effective treatment method for motor symptoms of advanced Parkinson's disease. DBS-electrode is implanted to subthalamic nucleus to give precisely allocated electrical stimuli to brain. The optimal stimulus type has to be adjusted individually. Disease severity, main symptoms and biological factors play a role in correctly setting up the device. Currently there are no objective methods to assess the efficacy of DBS, hence the adjustment is based solely on clinical assessment. In optimal case an objectively measurable feature would point the right settings of DBS. Surface electromyographic and kinematic measurements have been used in Parkinson's disease research. As Parkinson's disease symptoms are known to change the EMG signal properties, these methods could be helpful aid in the clinical adjustment of DBS. In this study, 13 patients with advanced Parkinson's disease who received DBS treatment were measured. The patients were measured with seven different settings of the DBS in clinical range including changes in stimulation amplitude, frequency and pulse width. The EMG analysis was based on parameters that characterize EMG signal morphology. Correlation dimension and recurrence rate made the most significant difference in relation to optimal settings. In conclusion, EMG analysis is able to detect differences between the DBS setups, and can help in finding the correct parameters.

Electromyography Biomarkers for Quantifying the Intraoperative Efficacy of Deep Brain Stimulation in Parkinson's Patients With Resting Tremor

“…However, to our knowledge, only five studies have investigated sEMG biomarkers for quantifying the efficacy of DBS, as described in previous studies (12,17,36,38). In line with previous studies, our results confirmed that sEMG features were sufficiently robust and sensitive to quantify the efficacy of DBS via three sEMG biomarkers: Peak(f)PSD, wRMS, and MNP.…”

“…In the past few years, sEMG has been proposed to discriminate patients from normal controls (14,33). It was also used to distinguish between essential tremor and tremor of PD through spectrally based methods, such as amplitude analysis (14), wavelet-based approaches (34,35), linear and non-linear parameters (33,36), EMG-burst shape analysis (36,37), and a principal component approach (12).…”

Expert committee classifier for hand motions recognition from EMG signals

“…These signals give an idea of the neuromuscular activity associated with a contraction, but does not necessarily indicates the force developed by the muscle, instead it gives the information of which muscle was activated by the central nervous system and which muscle provides indirectly a more leading role in a function or movement particularly [6]. EMG signals are used in the medical field for diagnosing muscle diseases such as myopathy, neuropathy [11] or Parkinson's disease [12] and, thanks to technological advances these signals are also used as control signals for electronic systems.…”

Quantitative Assessment of the Arm/Hand Movements in Parkinson’s Disease Using a Wireless Armband Device

“…Consequently, muscle activity tests are available only in the hospital environment. The analysis of the muscle activity is reported in some recent studies concerning PD ( 12 – 14 ). The authors in Ref.…”

“…The authors in Ref. ( 12 , 13 ) particularly observe the muscles’ behavior during deep brain stimulation. They report that Parkinson’s disease symptoms change the EMG signal properties and suggest that EMG analysis is able to detect differences between the deep brain stimulation settings.…”