Bimanual force coordination in Parkinson's disease patients with bilateral subthalamic deep brain stimulation.
Bimanual force coordination in Parkinson's disease patients with bilateral subthalamic deep brain stimulation.
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DOI：
10.1371/journal.pone.0078934
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Alberts JL
中科院分区：
文献类型：
--
作者：
Gorniak SL;McIntyre CC;Alberts JL
目前，在评估植入双侧丘脑下深部脑刺激器的帕金森病患者精细运动控制方面，缺乏类似于日常生活活动（adl）的双手动作的研究。我们研究了一组双侧丘脑下深部脑刺激（DBS）患者的基本时间和力特征，这些特征与adl的表现相似。在三种不同的DBS参数条件下对患者进行评估：非刺激、临床导出的刺激参数和基于患者特定计算模型的设置。通过Cicerone深部脑刺激软件计算基于模型的参数，以最大限度地减少电流向丘脑下核非运动区域的传播。在每种刺激条件下对患者进行帕金森药物评估。数据表明，在类adl任务中，DBS参数状态对精细运动控制的大部分方面没有影响；然而，握力增加和握力对称等特征随着刺激状态的变化而变化。在没有DBS参数的情况下，患者表现出明显的握力不对称。与非刺激条件相比，当患者经历临床衍生或基于模型的参数时，与手功能相关的总体UPDRS-III和UPDRS-III评分较低。虽然双侧丘脑底DBS已被证明可以缓解大运动功能障碍，但我们的研究结果表明，DBS可能无法为精细运动协调提供相同程度的益处。
Studies of bimanual actions similar to activities of daily living (ADLs) are currently lacking in evaluating fine motor control in Parkinson’s disease patients implanted with bilateral subthalamic deep brain stimulators. We investigated basic time and force characteristics of a bimanual task that resembles performance of ADLs in a group of bilateral subthalamic deep brain stimulation (DBS) patients. Patients were evaluated in three different DBS parameter conditions off stimulation, on clinically derived stimulation parameters, and on settings derived from a patient-specific computational model. Model-based parameters were computed as a means to minimize spread of current to non-motor regions of the subthalamic nucleus via Cicerone Deep Brain Stimulation software. Patients were evaluated off parkinsonian medications in each stimulation condition. The data indicate that DBS parameter state does not affect most aspects of fine motor control in ADL-like tasks; however, features such as increased grip force and grip symmetry varied with the stimulation state. In the absence of DBS parameters, patients exhibited significant grip force asymmetry. Overall UPDRS-III and UPDRS-III scores associated with hand function were lower while patients were experiencing clinically-derived or model-based parameters, as compared to the off-stimulation condition. While bilateral subthalamic DBS has been shown to alleviate gross motor dysfunction, our results indicate that DBS may not provide the same magnitude of benefit to fine motor coordination.
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