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Effects of deep brain stimulation and medication on strength, bradykinesia, and electromyographic patterns of the ankle joint in Parkinson's disease
Author(s) -
Vaillancourt David E.,
Prodoehl Janey,
Sturman Molly M.,
Bakay Roy A.E.,
Metman Leo Verhagen,
Corcos Daniel M.
Publication year - 2006
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.20672
Subject(s) - ankle , parkinson's disease , deep brain stimulation , subthalamic nucleus , physical medicine and rehabilitation , medicine , agonist , electromyography , physical therapy , surgery , disease , receptor
We investigated the control of movement in 12 patients with Parkinson's disease (PD) after they received surgically implanted high‐frequency stimulating electrodes in the subthalamic nucleus (STN). The experiment studied ankle strength, movement velocity, and the associated electromyographic patterns in PD patients, six of whom had tremor at the ankle. The patients were studied off treatment, ON STN deep brain stimulation (DBS), on medication, and on medication plus STN DBS. Twelve matched control subjects were also examined. Medication alone and STN DBS alone increased patients' ankle strength, ankle velocity, agonist muscle burst amplitude, and agonist burst duration, while reducing the number of agonist bursts during movement. These findings were similar for PD patients with and without tremor. The combination of medication plus STN DBS normalized maximal strength at the ankle joint, but ankle movement velocity and electromyographic patterns were not normalized. The findings are the first to demonstrate that STN DBS and medication increase strength and movement velocity at the ankle joint. © 2005 Movement Disorder Society