Subthalamic Stimulation for Camptocormia in Parkinson’s Disease: Association of Volume of Tissue Activated and Structural Connectivity with Clinical Effectiveness

Lai, Yijie; Yang, Song; Huang, Peng; Wang, Tao; Wang, Linbin; Pan, Yixin; Sun, Qiying; Sun, Bomin; Zhang, Chencheng; Li, Dianyou

doi:10.3233/jpd-202259

Cited by 11 publications

(27 citation statements)

References 46 publications

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“…Furthermore, in a small study of three patients with PD, two with bilateral DBS in the STN and one with bilateral GPi DBS, no or mild improvement of trunk flexion was seen in the two patients with DBS in the STN but a moderate improvement was seen in the patient with GPi DBS [ 41 ]. The results of the current study for DBS in the STN showed results that are more favorable (consistent with others, e.g., [ 4 ]) and could be a reflection of a longer interval between testing and DBS surgery. It should also be noted that in a systematic review by Chieng and colleagues [ 6 ], 68% of patients with PD saw an improvement to the degree of trunk flexion with DBS with an average reduction of 78.2% in flexion angle.…”

Section: Discussionsupporting

confidence: 91%

“…The GLM ANOVA of the main factor, vision, revealed that the movement amplitudes were larger with eyes closed than with eyes open at all recorded sites (p�0.020) (Table 5 and Fig 4). The main factor, adaptation, revealed that the PD group made marked reductions of the body movement over time at all recorded sites (p<0.001).…”

Section: Effects Of Dbs Vision and Adaptationmentioning

confidence: 89%

“…These findings suggest that alterations of posture, associated with greater forward leaning as calf vibration was repeated, are independent to movement amplitude changes. It is interesting to note that patients with PD experience greater reduction of trunk flexion with DBS in the STN if there is greater structural connectivity between the motor planning areas (right lateral premotor cortex and right supplementary motor area) and volume of tissue in the STN activated by DBS [ 4 ]. These cortical motor planning regions would be activated during the vibration task to generate adaptive responses.…”

Section: Discussionmentioning

confidence: 99%

“…Trunk position in PD has been measured or assumed from muscle echo intensity of the abdominal wall [ 18 ], from review of video recordings [ 4 , 19 ], subjectively using the 0–4 MDS Unified Parkinson’s Disease Rating Scale [ 20 – 22 ], or through observation [ 23 ]. Here, we use objective ultrasound motion detection to study and quantify alterations of body position in patients with PD and consider the longer-term effectiveness of DBS in the STN.…”

Section: Introductionmentioning

confidence: 99%

“…Levodopa or other dopamine agonists can increase the degree of trunk flexion. Deep brain stimulation (DBS) in the subthalamic nucleus (STN) can reduce the degree of trunk flexion [4][5][6] although a recent meta-analysis [7] has indicated variable effects. Further analysis appears to suggest that the effectiveness of DBS in the STN on trunk flexion is age dependent [8].…”

Section: Introductionmentioning

confidence: 99%

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Deep brain stimulation in the subthalamic nuclei alters postural alignment and adaptation in Parkinson’s disease

et al. 2021

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Parkinson’s disease (PD) can produce postural abnormalities of the standing body position such as kyphosis. We investigated the effects of PD, deep brain stimulation (DBS) in the subthalamic nucleus (STN), vision and adaptation on body position in a well-defined group of patients with PD in quiet standing and during balance perturbations. Ten patients with PD and 25 young and 17 old control participants were recruited. Body position was measured with 3D motion tracking of the ankle, knee, hip, shoulder and head. By taking the ankle as reference, we mapped the position of the joints during quiet standing and balance perturbations through repeated calf muscle vibration. We did this to explore the effect of PD, DBS in the STN, and vision on the motor learning process of adaptation in response to the repeated stimulus. We found that patients with PD adopt a different body position with DBS ON vs. DBS OFF, to young and old controls, and with eyes open vs. eyes closed. There was an altered body position in PD with greater flexion of the head, shoulder and knee (p≤0.042) and a posterior position of the hip with DBS OFF (p≤0.014). With DBS ON, body position was brought more in line with the position taken by control participants but there was still evidence of greater flexion at the head, shoulder and knee. The amplitude of movement during the vibration period decreased in controls at all measured sites with eyes open and closed (except at the head in old controls with eyes open) showing adaptation which contrasted the weaker adaptive responses in patients with PD. Our findings suggest that alterations of posture and greater forward leaning with repeated calf vibration, are independent from reduced movement amplitude changes. DBS in the STN can significantly improve body position in PD although the effects are not completely reversed. Patients with PD maintain adaptive capabilities by leaning further forward and reducing movement amplitude despite their kyphotic posture.

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Section: Discussionsupporting

confidence: 91%

Section: Effects Of Dbs Vision and Adaptationmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Deep brain stimulation in the subthalamic nuclei alters postural alignment and adaptation in Parkinson’s disease

et al. 2021

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Predictors and Pathophysiology of Axial Postural Abnormalities in Parkinsonism: A Scoping Review

Artusi,

Geroin,

Nonnekes

et al. 2023

Movement Disord Clin Pract

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BackgroundPostural abnormalities involving the trunk are referred to as axial postural abnormalities and can be observed in over 20% of patients with Parkinson disease (PD) and in atypical parkinsonism. These symptoms are highly disabling and frequently associated with back pain and a worse quality of life in PD. Despite their frequency, little is known about the pathophysiology of these symptoms and scant data are reported about their clinical predictors, making it difficult to prompt prevention strategies.ObjectivesWe conducted a scoping literature review of clinical predictors and pathophysiology of axial postural abnormalities in patients with parkinsonism to identify key concepts, theories and evidence on this topic.MethodsWe applied a systematic approach to identify studies, appraise quality of evidence, summarize main findings, and highlight knowledge gaps.ResultsNinety‐two articles were reviewed: 25% reported on clinical predictors and 75% on pathophysiology. Most studies identified advanced disease stage and greater motor symptoms severity as independent clinical predictors in both PD and multiple system atrophy. Discrepant pathophysiology data suggested different potential central and peripheral pathogenic mechanisms.ConclusionsThe recognition of clinical predictors and pathophysiology of axial postural abnormalities in parkinsonism is far from being elucidated due to literature bias, encompassing different inclusion criteria and measurement tools and heterogeneity of patient samples. Most studies identified advanced disease stage and higher burden of motor symptoms as possible clinical predictors. Pathophysiology data point towards many different (possibly non‐mutually exclusive) mechanisms, including dystonia, rigidity, proprioceptive and vestibular impairment, and higher cognitive deficits.This article is protected by copyright. All rights reserved.

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Exploring the network effects of deep brain stimulation for rapid eye movement sleep behavior disorder in Parkinson’s disease

Zhao,

Cheng,

Wang

et al. 2023

Acta Neurochir

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Subthalamic Stimulation for Camptocormia in Parkinson’s Disease: Association of Volume of Tissue Activated and Structural Connectivity with Clinical Effectiveness

Cited by 11 publications

References 46 publications

Deep brain stimulation in the subthalamic nuclei alters postural alignment and adaptation in Parkinson’s disease

Deep brain stimulation in the subthalamic nuclei alters postural alignment and adaptation in Parkinson’s disease

Predictors and Pathophysiology of Axial Postural Abnormalities in Parkinsonism: A Scoping Review

Exploring the network effects of deep brain stimulation for rapid eye movement sleep behavior disorder in Parkinson’s disease

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