Journal Mobile Options
Table of Contents
Vol. 62, No. 2, 2009
Issue release date: July 2009
Eur Neurol 2009;62:114–119
(DOI:10.1159/000222783)

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

Pötter-Nerger M. · Wenzelburger R. · Deuschl G. · Volkmann J.
Department of Neurology, Christian Albrecht University, Kiel, Germany

Individual Users: Register with Karger Login Information

Please create your User ID & Password





Contact Information











I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Abstract

Objective: To evaluate the usefulness of a new instrument for bedside testing of proximal arm and distal finger tapping performance in patients with Parkinson’s disease (PD). Methods: Twenty healthy controls and 25 PD patients with subthalamic nucleus deep brain stimulation were investigated in different treatment conditions using three different tapping paradigms: (1) the standard tapping task of the CAPSIT-PD-protocol; (2) alternate pressing of two buttons on the new board by moving the arm at the elbow and shoulder (proximal tapping), and (3) alternate pressing of two closely collocated buttons on the new board by moving only the index finger (distal tapping) for 30 s. Results: The new tapping board was as sensitive as the standard board to distinguish untreated PD patients from controls. The relative improvements in tapping scores from the off treatment condition were largest for the proximal tapping task. The treatment effects of high frequency stimulation of the subthalamic nucleus or medication alone were comparable, whereas the combined treatment induced significantly higher tapping scores. Conclusion: The new tapping board represents a quick and easy to use bedside test, which may be routinely used to probe the efficacy of treatments on different aspects of motor control.



Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Dafotakis M, et al: The impact of subthalamic deep brain stimulation on bradykinesia of proximal and distal upper limb muscles in Parkinson’s disease. J Neurol 2008;255:429–437.
  2. Timmermann L, et al: Differential effects of levodopa and subthalamic nucleus deep brain stimulation on bradykinesia in Parkinson’s disease. Mov Disord 2008;23:218–227.
  3. Krakauer J, Ghez C: Voluntary Movement; in Kandel ER, Schwartz JH, Jessell TM (eds): Principles of Neural Science. McGraw-Hill Companies, 2000, pp 756–781.
  4. Wenzelburger R, et al: Subthalamic nucleus stimulation for Parkinson’s disease preferentially improves akinesia of proximal arm movements compared to finger movements. Mov Disord 2003;18:1162–1169.
  5. Hughes AJ, Lees AJ, Stern GM: Challenge tests to predict the dopaminergic response in untreated Parkinson’s disease. Neurology 1991;41:1723–1725.
  6. Hughes AJ, Lees AJ, Stern GM: Apomorphine test to predict dopaminergic responsiveness in parkinsonian syndromes. Lancet 1990;336:32–34.
  7. Krack P, et al: Subthalamic nucleus or internal pallidal stimulation in young onset Parkinson’s disease. Brain 1998;121:451–457.
  8. Wenzelburger R, et al: Force overflow and levodopa-induced dyskinesias in Parkinson’s disease. Brain 2002;125:871–879.
  9. Herzog J, et al: Two-year follow-up of subthalamic deep brain stimulation in Parkinson’s disease. Mov Disord 2003;18:1332–1337.
  10. D’Costa DF, et al: The apomorphine test in parkinsonian syndromes. J Neurol Neurosurg Psychiatry 1991;54:870–872.
  11. Gasser T, et al: Apomorphine test for dopaminergic responsiveness in patients with previously untreated Parkinson’s disease. Arch Neurol 1992;49:1131–1134.
  12. Nutt JG, et al: Effect of long-term therapy on the pharmacodynamics of levodopa. Relation to on-off phenomenon. Arch Neurol 1992;49:1123–1130.
  13. Lemon RN, Johansson RS, Westling G: Modulation of corticospinal influence over hand muscles during gripping tasks in man and monkey. Can J Physiol Pharmacol 1996;74:547–558.
  14. Colebatch JG, et al: Regional cerebral blood flow during voluntary arm and hand movements in human subjects. J Neurophysiol 1991;65:1392–1401.
  15. Deiber MP, et al: Cortical areas and the selection of movement: a study with positron emission tomography. Exp Brain Res 1991;84:393–402.
  16. Jeannerod M: The formation of finger grip during prehension. A cortically mediated visuomotor pattern. Behav Brain Res 1986;19:99–116.
  17. Freund HJ, Hummelsheim H: Lesions of premotor cortex in man. Brain 1985;108:697–733.
  18. Nandi D, et al: Brainstem motor loops in the control of movement. Mov Disord 2002;17(suppl 3):S22–S27.
  19. Nandi D, et al: Deep brain stimulation of the pedunculopontine region in the normal non-human primate. J Clin Neurosci 2002;9:170–174.


Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50