Effects of five years of chronic STN stimulation on muscle strength and movement speed |
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Authors: | Molly M Sturman David E Vaillancourt Leo Verhagen Metman Roy A E Bakay Daniel M Corcos |
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Institution: | (1) Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 West Taylor Street, 650 AHSB, M/C 994, Chicago, IL 60612, USA;(2) Department of Bioengineering, University of Illinois at Chicago, Chicago, IL, USA;(3) Department of Neurology and Rehabilitation, University of Illinois at Chicago, Chicago, IL, USA;(4) Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL, USA;(5) Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA;(6) Department of Neurosurgery, Rush University Medical Center, Chicago, IL, USA |
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Abstract: | This study examined the long-term effects of chronic subthalamic nucleus (STN) deep brain stimulation (DBS) using both clinical
evaluation and laboratory motor control measures. Over a 5-year time period, changes in the motor section of the Unified Parkinson’s
Disease Rating Scale (UPDRS) and movement speed and strength at the ankle joint were evaluated on and off STN DBS in eight
patients with Parkinson’s disease (PD). Four patients were also studied at the elbow joint. Patients with PD originally received
unilateral STN DBS between years 2001 and 2003. They were re-evaluated after 5 years of long-term STN DBS between years 2006–2008.
At baseline (year 0) and after 5 years, patients with PD were tested off treatment and on STN DBS. In each testing condition,
patients performed ballistic, single degree of freedom ankle dorsiflexion and ankle plantarflexion movements and peak velocity
was calculated. Patients also performed maximal voluntary contractions at the ankle joint in both directions, and peak torque
was calculated. Results showed increased motor UPDRS scores from year 0 to year 5, but STN DBS was efficacious in reducing
them. In contrast to the increase in motor UPDRS scores, motor control results showed a marked improvement in peak velocity
and peak torque over the 5-year time period in the off treatment condition, and STN DBS was efficacious by improving both
peak velocity and peak torque. The current findings suggest that 5 years of chronic STN DBS can have beneficial effects on
the motor system over the long term in discrete motor tasks in which maximal effort and maximal neural output is required. |
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