DOI QR코드

DOI QR Code

Quantification of the Effect of Medication and Deep Brain Stimulation on Parkinsonian Rigidity

파킨슨병 환자의 경직에 대한 약물과 DBS 의 효과의 정량화

  • Kwon, Yu-Ri (School of Biomedical Engineering, Konkuk Univ.) ;
  • Eom, Gwang-Moon (School of Biomedical Engineering, Konkuk Univ.) ;
  • Park, Sang-Hun (School of Biomedical Engineering, Konkuk Univ.) ;
  • Kim, Ji-Won (School of Biomedical Engineering, Konkuk Univ.) ;
  • Kim, Min-Jik (Department of Neurology, Korea University College of Medicine) ;
  • Lee, Hye-Mi (Department of Neurology, Korea University College of Medicine) ;
  • Jang, Ji-Wan (Department of Neurology, Korea University College of Medicine) ;
  • Koh, Seong-Beom (Department of Neurology, Korea University College of Medicine)
  • Received : 2012.08.20
  • Accepted : 2013.03.25
  • Published : 2013.05.01

Abstract

This study aims to quantify the effects of medication (Med) and deep brain stimulation (DBS) on resting rigidity in patients with Parkinson's disease. We tested 10 limbs of five patients under each of four treatment conditions: 1) baseline, 2) DBS, 3) Med, 4) DBS + Med. Rigidity at the wrist joint was assessed using the Unified Parkinson's Disease Rating Scale (UPDRS). The examiner randomly imposed flexion and extension movement on patient's wrist joint. Resistance to passive movement was quantified by viscoelastic properties. Not only rigidity score but also damping constant showed improvements in rigidity by DBS and Med treatments (p<0.05). This indicates that the viscosity can represent the change in rigidity due to DBS as well as Med, which was manifested by UPDRS score.

Keywords

References

  1. Xia, R. and Rymer, W. Z., "The role of shortening reaction in mediating rigidity in Parkinson's disease," Exp. Brain Res., Vol. 156, No. 4, pp. 524-528, 2004. https://doi.org/10.1007/s00221-004-1919-9
  2. Horstink, M., Tolosa, E., Bonuccelli, U., Deuschl, G., Friedman, A., Kanovsky, P., Larsen, J. P., Lees, A., Oertel, W., Poewe, W., Rascol, O., and Sampaio, C., "Review of the therapeutic management of Parkinson's disease. Report of a joint task force of the European Federation of Neurological Societies (EFNS) and the Movement Disorder Society- European Section (MDS-ES). Part II: late (complicated) Parkinson's disease," European Federation of Neurological Societies, Vol. 13, No. 11, pp. 1186-1202, 2006. https://doi.org/10.1111/j.1468-1331.2006.01548.x
  3. Chen, C. C., Lee, S. T., Wu, T., Chen, C. J., Chen, M. C., and Lu, C. S., "Short-term effect of bilateral subthalamic stimulation for advanced Parkinson's disease," Chang. Gung. Med. J., Vol. 26, No. 5, pp. 344-351, 2003.
  4. Varma, T. R., Fox, S. H., Eldridge, P. R., Littlechild, P., Byrne, P., Forster, A., Marshall, A., Cameron, H., McIver, K., Fletcher, N., and Steiger, M., "Deep brain stimulation of the subthalamic nucleus: effectiveness in advanced Parkinson's disease patients previously reliant on apomorphine," J. Neurol Neurosurg. Psychiatry., Vol. 74, No. 2, pp. 170-174, 2003. https://doi.org/10.1136/jnnp.74.2.170
  5. Kim, J. H., Kwon, T. H., Koh, S. B., and Park, J. Y., "Parkinsonism-hyperpyrexia syndrome after deep brain stimulation surgery: case report," Neurosurgery, Vol. 66, No. 5, pp. E1029, 2010. https://doi.org/10.1227/01.NEU.0000367799.38332.43
  6. Xia, R., Markopoulou, K., Puumala, S. E., and Rymer, W. Z., "A comparison of the effects of imposed extension and flexion movements on Parkinsonian rigidity," Clinical Neurophysiology, Vol. 117, pp. 2302-2307, 2006. https://doi.org/10.1016/j.clinph.2006.06.176
  7. Shapiro, M. B., Vaillancourt, D. E., Sturman, M. M., Metman, L. V., Bakay, R. A., and Corcos, D. M., "Effects of STN DBS on Rigidity in Parkinson's Disease," IEEE Trans. Neural. Syst. Rehabil. Eng., Vol. 15, No. 2, pp. 173-181, 2007. https://doi.org/10.1109/TNSRE.2007.896997
  8. Hamani, C., Richter, E., Schwalb, J. M., and Lozano, A. M., "Bilateral subthalamic nucleus stimulation for Parkinson's disease: a systematic review of the clinical literature," Neurosurgery, Vol. 55, No. 6, pp. 1313-1321, 2005.
  9. Park, B. K., Kwon, Y., Kim, J. W., Lee, J. H., Eom, G. M., Koh, S. B., Jun, J. H., and Hong, J., "Analysis of viscoelastic properties of wrist joint for quantification of parkinsonian rigidity," IEEE Trans. Neural. Syst. Rehabil. Eng., Vol. 19, No. 2, pp. 167-176, 2011. https://doi.org/10.1109/TNSRE.2010.2091149
  10. Kwon, Y. R., Park, S. H., Kim, J. W., Koh, S. B., Park, B. K., and Eom, G. M., "Effect of Intraoperative Deep Brain Stimulation on Viscoelastic Properties of Parkinsonian Rigidity during Surgery," J. of KSPE, Vol. 29, No. 9, pp. 1035-1040, 2012. https://doi.org/10.7736/KSPE.2012.29.9.1035
  11. Defer, G. L., Widner, H., Marie, R. M., Remy, P., and Levivier, M., "Core assessment program for surgical interventional therapies in Parkinson's disease (CAPSIT-PD)," Mov. Disord., Vol. 14, No. 4, pp. 572-584, 1999. https://doi.org/10.1002/1531-8257(199907)14:4<572::AID-MDS1005>3.0.CO;2-C

Cited by

  1. Design and Implementation of Low-power Neuromodulation S/W based on MSP430 vol.53, pp.7, 2016, https://doi.org/10.5573/ieie.2016.53.7.110