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Title

Dyskinesias and grip control in Parkinson's disease are normalized by chronic stimulation of the subthalamic nucleus

Authors
Wenzelburger, Roland
Zhang, Bao-Rong
Poepping, Meike
Schrader, Bettina
Müller, Dieter
Kopper, Florian
Fietzek, Urban
Mehdorn, Hubertus M
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Published in Annals of Neurology. 2002, vol. 52, no. 2, p. 240-3
Abstract Deep-brain stimulation of the subthalamic nucleus appears to reduce levodopa-induced dyskinesias, but whether this effect is caused by the reduction of the total levodopa ingestion or represents a direct effect on the motor system is unknown. Precision grip force of grasping movements and levodopa-induced dyskinesias was analyzed in 10 parkinsonian patients before and after 3 months of deep-brain stimulation of the subthalamic nucleus. Peak grip force was abnormally increased before surgery in the off-drug state and, particularly, in the on-drug state (sensitization). This grip force upregulation normalized with chronic deep-brain stimulation in both conditions (desensitization). Peak-dose dyskinesias also improved, and off-dystonia was completely abolished. Mean dosage of dopaminergic drugs was reduced, but force overflow and dyskinesias were equally improved in 2 patients without a reduction. Despite the same single levodopa test dose, force excess and levodopa-induced dyskinesias were drastically reduced after 3 months of deep-brain stimulation of the subthalamic nucleus. This indicates that direct effects of deep-brain stimulation of the subthalamic nucleus on levodopa-induced dyskinesias are likely to occur. Grip force overflow is a promising parameter to study the desensitizing effect of chronic deep-brain stimulation on levodopa-induced dyskinesias.
Keywords Dose-Response Relationship, DrugDyskinesias/etiology/physiopathology/therapyElectric Stimulation TherapyHand StrengthHumansLevodopa/administration & dosage/therapeutic useParkinson Disease/complicationsReference ValuesSeverity of Illness IndexSubthalamic Nucleus/physiopathologyTime Factors
Identifiers
PMID: 12210799
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WENZELBURGER, Roland et al. Dyskinesias and grip control in Parkinson's disease are normalized by chronic stimulation of the subthalamic nucleus. In: Annals of Neurology, 2002, vol. 52, n° 2, p. 240-3. https://archive-ouverte.unige.ch/unige:94554

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Deposited on : 2017-05-30

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