The impact of subthalamic deep brain stimulation on bradykinesia of proximal and distal upper limb muscles in Parkinson's disease

Abstract

The data suggest that bilateral stimulation of the subthalamic nucleus improves bradykinesia of both distal and proximal muscles of the arm and hand in Parkinson's disease; however, dependent upon task complexity proximal and distal movement components may be affected differentially. Kinematic motion analysis is an efficient tool to objectively evaluate the beneficial effects of subthalamic nucleus stimulation on dexterity in Parkinson's disease.

Impact of Subthalamic Stimulation and Medication on Proximal and Distal Bradykinesia in Parkinson’s Disease

“…In another study, STN-HFS had an impact on simple alternating distal (index finger tapping) and proximal movements (pointing), when tested in isolation. However, there was a differential impact of STN-HFS on finger bradykinesia within a complex reach-to-grasp task where both components were combined [1]. Our data corroborate these findings by demonstrating significant improvements in distal and proximal tapping with STN-HFS compared with the off state, but a greater impact on the proximal tapping task compared with the distal tapping.…”

“…Recently, there has been an interest in distinguishing proximal from distal arm bradykinesia in PD [1, 2, 4], as they are thought to originate within different neuronal networks and seem to respond differently to treatment. The aim of this study was to evaluate a simple tapping device, which measures the speed of repetitive alternating proximal and distal arm movements in PD.…”

“…One established paradigm for quantifying upper limb akinesia is a grasp-and-lift task, in which the time course of the grip force, exerted by distal arm muscles, and the load (lifting) force, exerted mainly by proximal arm muscles, are measured [4]. Another paradigm employs optokinetic or ultrasound-based kinematic analysis of reach-to-grasp movements, which involve proximal muscle activation during the transport phase and distal muscle activation during the precision grip [1]. However, these techniques have two disadvantages.…”

“…From a clinical and physiological perspective, it may be useful to differentiate between proximal and distal upper extremity bradykinesia in Parkinson’s disease (PD) [1, 2]. Evidence from invasive recordings in non-human primates and functional neuroimaging in humans suggests segregated functional neuronal circuits for the control of fine distal finger movements and proximal reaching movements, with a more prominent involvement of the primary motor cortex and lateral ventral premotor cortex in distal motor control and the SMA, and the involvement of the dorsal premotor cortex and brainstem areas including the PPN in proximal motor programming [3].…”

Feature Extraction Methods for Studying Surface Electromyography and Kinematic Measurements in Parkinson’s Disease

“…It has been observed that the medication and DBS may modify the tremor amplitude, regularity and frequency [4,41,42], movement speed [3,8,34,40,44,49,51,52], joint kinetics and muscle activation during movements [55], EMG burst patterns during movement [34,51,52] and the cortico-muscular coherence [25,37]. There is currently a lot of interest for characterizing EMG and kinematic signals of PD patients.…”