Skip to main content
SpringerLink
Log in

Effects of medication and deep brain stimulation on speed and amplitude are different between finger and forearm in patient with Parkinson’s disease

  • Published:
International Journal of Precision Engineering and Manufacturing Aims and scope Submit manuscript

Abstract

Although differential effects of medication and deep brain stimulation (DBS) on bradykinesia have been addressed in the literature, speed and amplitude have not been separated. This study investigated the differential effects of medication and DBS on quantitative measures of speed and amplitude, as well as on proximal and distal muscles of upper extremities. Fourteen upper limbs affected by Parkinson’s disease were tested. Finger tapping and forearm rotation were performed to investigate distal and proximal bradykinesia, respectively. Test conditions included off-treatment, DBS only, medication only, and medication + DBS. Quantitative outcome measures included root-mean-square average of speed and amplitude. Two-way and one-way ANOVA (analysis of variance) were performed to investigate the effects of medication and DBS, and to compare the performance in four test conditions, respectively. Speed was improved at both body parts, whereas amplitude was improved only at the proximal forearm (p < 0.01). Medication tended to be better than DBS at distal speed, whereas DBS tended to be better than medication at proximal amplitude. Medication + DBS resulted in the best average performance in all outcome measures. Improvement in speed and amplitude in each body parts are differentially associated with medication and DBS. Medication and DBS have complementary effects in amelioration of bradykinesia. The findings may be helpful for clinical interventions and evaluations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Espay, A. J., Beaton, D. E., Morgante, F., Gunraj, C. A., Lang, A. E., and Chen, R., “Impairments of speed and amplitude of movement in Parkinson’s disease: a pilot study,” Mov. Disord., Vol. 24, No.7, pp. 1001–1008, 2009.

    Article  Google Scholar 

  2. Lyons, K. E., Pahwa, R., Troster, A. I., and Koller, W. C., “A comparison of Parkinson’s disease symptoms and self-reported functioning and well being,” Parkinsonism. Relat. Disord., Vol. 3, No. 4, pp. 207–209, 1997.

    Article  Google Scholar 

  3. Dural, A., Atay, M. B., Akbostanci, C., and Kucukdeveci, A., “Impairment, disability, and life satisfaction in Parkinson’s disease,” Disabil. Rehabil., Vol. 25, No. 7, pp. 318–323, 2003.

    Article  Google Scholar 

  4. Vaillancourt, D. E., Prodoehl, J., Verhagen Metman, L., Bakay, R. A., and Corcos, D. M., “Effects of deep brain stimulation and medication on bradykinesia and muscle activation in Parkinson’s disease,” Brain, Vol. 127, No. 3, pp. 491–504, 2004.

    Article  Google Scholar 

  5. Sturman, M. M., Vaillancourt, D. E., Metman, L. V., Bakay, R. A., and Corcos, D. M., “Effects of five years of chronic STN stimulation on muscle strength and movement speed,” Exp Brain Res, Vol. 205, No. 4, pp. 435–443, 2010.

    Article  Google Scholar 

  6. Vaillancourt, D. E., Prodoehl, J., Sturman, M. M., Bakay, R. A., Metman, L. V., and Corcos, D. M., “Effects of deep brain stimulation and medication on strength, bradykinesia, and electromyographic patterns of the ankle joint in Parkinson’s disease,” Mov. Disord., Vol. 21, No. 1, pp. 50–58, 2006.

    Article  Google Scholar 

  7. Wenzelburger, R., Kopper, F., Zhang, B. R., Witt, K., Hamel, W., Weinert, D., Kuhtz-Buschbeck, J., Golge, M., Illert, M., Deuschl, G., and Krack, P., “Subthalamic nucleus stimulation for Parkinson’s disease preferentially improves akinesia of proximal arm movements compared to finger movements,” Mov. Disord., Vol. 18, No. 10, pp. 1162–1169, 2003.

    Article  Google Scholar 

  8. Timmermann, L., Braun, M., Groiss, S., Wojtecki, L., Ostrowski, S., Krause, H., Pollok, B., Sudmeyer, M., Ploner, M., Gross, J., Maarouf, M., Voges, J., Sturm, V., and Schnitzler, A., “Differential effects of levodopa and subthalamic nucleus deep brain stimulation on bradykinesia in Parkinson’s disease,” Mov. Disord., Vol. 23, No. 2, pp. 218–227, 2008.

    Article  Google Scholar 

  9. Goetz, C. G., Tilley, B. C., Shaftman, S. R., Stebbins, G. T., Fahn, S., Martinez-Martin, P., Poewe, W., Sampaio, C., Stern, M. B., Dodel, R., Dubois, B., Holloway, R., Jankovic, J., Kulisevsky, J., Lang, A. E., Lees, A., Leurgans, S., LeWitt, P. A., Nyenhuis, D., Olanow, C. W., Rascol, O., Schrag, A., Teresi, J. A., Van Hilten, J. J., and LaPelle, N., “Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): scale presentation and clinimetric testing results,” Mov. Disord., Vol. 23, No. 15, pp. 2129–2170, 2008.

    Article  Google Scholar 

  10. Kim, J. W., Lee, J. H., Kwon, Y., Kim, C. S., Eom, G. M., Koh, S. B., Kwon, D. Y., and Park, K. W., “Quantification of bradykinesia during clinical finger taps using a gyrosensor in patients with Parkinson’s disease,” Med. Biol. Eng. Comput., Vol. 49, No. 3, pp. 365–371, 2011.

    Article  Google Scholar 

  11. Kim, J. W., Kwon, Y., Kim, Y. M., Chung, H. Y., Eom, G. M., Jun, J. H., Lee, J. W., Koh, S. B., Park, B. K., and Kwon, D. K., “Analysis of lower limb bradykinesia in Parkinson’s disease patients,” Geriatr. Gerontol. Int., Vol. 12, No. 2, pp. 257–264, 2012.

    Article  Google Scholar 

  12. http://www.mdvu.org/library/ratingscales/pd/ (Accessed 14 June 2013)

  13. Chae, J., Yang, G., Park, B. K., and Labatia, I., “Delay in initiation and termination of muscle contraction, motor impairment, and physical disability in upper limb hemiparesis,” Muscle Nerve, Vol. 25, No. 4, pp. 568–575, 2002.

    Article  Google Scholar 

  14. Potter-Nerger, M., Wenzelburger, R., Deuschl, G., and Volkmann, J., “Impact of subthalamic stimulation and medication on proximal and distal bradykinesia in Parkinson’s disease,” Eur. Neurol., Vol. 62, No. 2, pp. 114–119, 2009.

    Article  Google Scholar 

  15. Espay, A. J., Giuffrida, J. P., Chen, R., Payne, M., Mazzella, F., Dunn, E., Vaughan, J. E., Duker, A. P., Sahay, A., Kim, S. J., Revilla, F. J., and Heldman, D. A., “Differential response of speed, amplitude, and rhythm to dopaminergic medications in Parkinson’s disease,” Mov. Disord., Vol. 26, No. 14, pp. 2504–2508, 2011.

    Article  Google Scholar 

  16. Krakauer, J. and Ghez, C., “Voluntary Movement, In: Kandel, E. R., Schwartz, J. H., and Jessell, T. M. (eds.), Principles of Neural Science,” McGraw-Hill Companies 4th Edition, pp. 756–781, 2000.

    Google Scholar 

  17. Rascol, O., Sabatini, U., Chollet, F., Celsis, P., Montastruc, J. L., Marc-Vergnes, J. P., and Rascol, A., “Supplementary and primary sensory motor area activity in Parkinson’s disease. Regional cerebral blood flow changes during finger movements and effects of apomorphine,” Arch. Neurol., Vol. 49, No. 2, pp. 144–148, 1992.

    Article  Google Scholar 

  18. Ceballos-Baumann, A. O., Boecker, H., Bartenstein, P., von Falkenhayn, I., Riescher, H., Conrad, B., Moringlane, J. R., and Alesch, F., “A positron emission tomographic study of subthalamic nucleus stimulation in Parkinson disease: enhanced movementrelated activity of motor-association cortex and decreased motor cortex resting activity,” Arch. Neurol., Vol. 56, No. 8, pp. 997–1003, 1999.

    Article  Google Scholar 

  19. Jenkins, I. H., Fernandez, W., Playford, E. D., Lees, A. J., Frackowiak, R. S., Passingham, R. E., and Brooks, D. J., “Impaired activation of the supplementary motor area in Parkinson’s disease is reversed when akinesia is treated with apomorphine,” Ann. Neurol., Vol. 32, No. 6, pp. 749–757, 1992.

    Article  Google Scholar 

  20. Hilker, R., Voges, J., Thiel, A., Ghaemi, M., Herholz, K., Sturm, V., and Heiss, W. D., “Deep brain stimulation of the subthalamic nucleus versus levodopa challenge in Parkinson’s disease: measuring the on- and off-conditions with FDG-PET,” J. Neural. Transm., Vol. 109, No. 10, pp. 1257–1264, 2002.

    Article  Google Scholar 

  21. Gross, J., Pollok, B., Dirks, M., Timmermann, L., Butz, M., and Schnitzler, A., “Task-dependent oscillations during unimanual and bimanual movements in the human primary motor cortex and SMA studied with magnetoencephalography,” Neuroimage, Vol. 26, No.1, pp. 91–98, 2005.

    Article  Google Scholar 

  22. Moore, S. T., MacDougall, H. G., Gracies, J. M., Cohen, H.S., and Ondo, W. G., “Long-term monitoring of gait in Parkinson’s disease,” Gait Posture, Vol. 26, No. 2, pp. 200–207, 2007.

    Article  Google Scholar 

  23. Jun, J. H., Kim, J. W., Kwon, Y., Eom, G. M., Koh, S. B., Lee, B. S., Kim, H. S., Yi, J. H., and Tack, G. R., “Quantification of limb bradykinesia in patients with Parkinson’s disease using a gyrosensor — Improvement and validation,” Int. J. Precis. Eng. Manuf., Vol. 12, No. 3, pp. 557–563, 2011.

    Article  Google Scholar 

  24. Brown, J. D., “Effect size and eta squared.” Shiken: JALT Testing & Evaluation SIG Newsletter, Vol. 12, No. 2, pp. 38–43, 2008.

    Google Scholar 

  25. 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. 56, No. 6, pp. 1313–1324, 2005.

    Article  Google Scholar 

  26. Levin, J., Krafczyk, S., Valkovic, P., Eggert, T., Claassen, J., and Botzel, K., “Objective measurement of muscle rigidity in Parkinsonian patients treated with subthalamic stimulation,” Mov. Disord., Vol. 24, No. 1, pp. 57–63, 2009.

    Article  Google Scholar 

  27. 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.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Biomedical Engineering, Konkuk University, 268 Chungwon-daero, Chungju-si, Chungbuk, Korea, 380-701

    Ji-Won Kim, Yuri Kwon, Yeji Ho, Chul-Seung Kim, Gwang-Moon Eom, Jae-Hoon Jun, Jeong-Whan Lee & Kyeong-Seop Kim

  2. Research Institute of Biomedical Engineering, Konkuk University, 268 Chungwon-daero, Chungju-si, Chungbuk, Korea, 380-701

    Gwang-Moon Eom, Jeong-Whan Lee & Kyeong-Seop Kim

  3. Department of Neurology, Korea University College of Medicine, Seoul, Korea, 136-705

    Min-Jik Kim & Seong-Beom Koh

Authors
  1. Ji-Won Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yuri Kwon
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yeji Ho
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sang-Hoon Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Chul-Seung Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Gwang-Moon Eom
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jae-Hoon Jun
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Jeong-Whan Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Kyeong-Seop Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Min-Jik Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Seong-Beom Koh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gwang-Moon Eom.

Additional information

These authors equally contributed as corresponding authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kim, JW., Kwon, Y., Ho, Y. et al. Effects of medication and deep brain stimulation on speed and amplitude are different between finger and forearm in patient with Parkinson’s disease. Int. J. Precis. Eng. Manuf. 14, 1201–1207 (2013). https://doi.org/10.1007/s12541-013-0163-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12541-013-0163-2

Keywords

Search

Navigation