La maladie de Parkinson au Canada (serveur d'exploration)

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Disruption in proprioception from long-term thalamic deep brain stimulation: a pilot study

Identifieur interne : 000321 ( Pmc/Checkpoint ); précédent : 000320; suivant : 000322

Disruption in proprioception from long-term thalamic deep brain stimulation: a pilot study

Auteurs : Jennifer A. Semrau [Canada] ; Troy M. Herter [États-Unis] ; Zelma H. Kiss [Canada] ; Sean P. Dukelow [Canada]

Source :

RBID : PMC:4416461

Abstract

Deep brain stimulation (DBS) is an excellent treatment for tremor and is generally thought to be reversible by turning off stimulation. For tremor, DBS is implanted in the ventrointermedius (Vim) nucleus of the thalamus, a region that relays proprioceptive information for movement sensation (kinaesthesia). Gait disturbances have been observed with bilateral Vim DBS, but the long-term effects on proprioceptive processing are unknown. We aimed to determine whether Vim DBS surgical implantation or stimulation leads to proprioceptive deficits in the upper limb. We assessed two groups of tremor subjects on measures of proprioception (kinaesthesia, position sense) and motor function using a robotic exoskeleton. In the first group (Surgery), we tested patients before and after implantation of Vim DBS, but before DBS was turned on to determine if proprioceptive deficits were inherent to tremor or caused by DBS implantation. In the second group (Stim), we tested subjects with chronically implanted Vim DBS ON and OFF stimulation. Compared to controls, there were no proprioceptive deficits before or after DBS implantation in the Surgery group. Surprisingly, those that received chronic long-term stimulation (LT-stim, 3–10 years) displayed significant proprioceptive deficits ON and OFF stimulation not present in subjects with chronic short-term stimulation (ST-stim, 0.5–2 years). LT-stim had significantly larger variability and reduced workspace area during the position sense assessment. During the kinesthetic assessment, LT-stim made significantly larger directional errors and consistently underestimated the speed of the robot, despite generating normal movement speeds during motor assessment. Chronic long-term Vim DBS may potentially disrupt proprioceptive processing, possibly inducing irreversible plasticity in the Vim nucleus and/or its network connections. Our findings in the upper limb may help explain some of the gait disturbances seen by others following Vim DBS.


Url:
DOI: 10.3389/fnhum.2015.00244
PubMed: 25983689
PubMed Central: 4416461


Affiliations:


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PMC:4416461

Le document en format XML

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</TEI>
<pmc article-type="research-article">
<pmc-dir>properties open_access</pmc-dir>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">Front Hum Neurosci</journal-id>
<journal-id journal-id-type="iso-abbrev">Front Hum Neurosci</journal-id>
<journal-id journal-id-type="publisher-id">Front. Hum. Neurosci.</journal-id>
<journal-title-group>
<journal-title>Frontiers in Human Neuroscience</journal-title>
</journal-title-group>
<issn pub-type="epub">1662-5161</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">25983689</article-id>
<article-id pub-id-type="pmc">4416461</article-id>
<article-id pub-id-type="doi">10.3389/fnhum.2015.00244</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Neuroscience</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Disruption in proprioception from long-term thalamic deep brain stimulation: a pilot study</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Semrau</surname>
<given-names>Jennifer A.</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
<uri xlink:type="simple" xlink:href="http://community.frontiersin.org/people/u/212155"></uri>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Herter</surname>
<given-names>Troy M.</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>3</sup>
</xref>
<uri xlink:type="simple" xlink:href="http://community.frontiersin.org/people/u/143308"></uri>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Kiss</surname>
<given-names>Zelma H.</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
<xref ref-type="author-notes" rid="fn001">
<sup>*</sup>
</xref>
<uri xlink:type="simple" xlink:href="http://community.frontiersin.org/people/u/212106"></uri>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Dukelow</surname>
<given-names>Sean P.</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
<uri xlink:type="simple" xlink:href="http://community.frontiersin.org/people/u/105086"></uri>
</contrib>
</contrib-group>
<aff id="aff1">
<sup>1</sup>
<institution>Hotchkiss Brain Institute, University of Calgary</institution>
<country>Calgary, AB, Canada</country>
</aff>
<aff id="aff2">
<sup>2</sup>
<institution>Department of Clinical Neurosciences, University of Calgary</institution>
<country>Calgary, AB, Canada</country>
</aff>
<aff id="aff3">
<sup>3</sup>
<institution>Department of Exercise Science, University of South Carolina</institution>
<country>Columbia, SC, USA</country>
</aff>
<author-notes>
<fn fn-type="edited-by">
<p>Edited by: Rachael D. Seidler, University of Michigan, USA</p>
</fn>
<fn fn-type="edited-by">
<p>Reviewed by: Vadim Nikulin, Charite University Hospital, Germany; Andrea A. Kühn, Charité, University-Medicine Berlin, Germany</p>
</fn>
<corresp id="fn001">*Correspondence: Zelma H. Kiss, Department of Clinical Neurosciences, Room 1AC58 HRIC, 2380 Hospital Dr. NW, Calgary, AB T2N4N1, Canada
<email xlink:type="simple">zkiss@ucalgary.ca</email>
</corresp>
</author-notes>
<pub-date pub-type="epub">
<day>01</day>
<month>5</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="collection">
<year>2015</year>
</pub-date>
<volume>9</volume>
<elocation-id>244</elocation-id>
<history>
<date date-type="received">
<day>11</day>
<month>2</month>
<year>2015</year>
</date>
<date date-type="accepted">
<day>15</day>
<month>4</month>
<year>2015</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright © 2015 Semrau, Herter, Kiss and Dukelow.</copyright-statement>
<copyright-year>2015</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/4.0/">
<license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</license-p>
</license>
</permissions>
<abstract>
<p>Deep brain stimulation (DBS) is an excellent treatment for tremor and is generally thought to be reversible by turning off stimulation. For tremor, DBS is implanted in the ventrointermedius (Vim) nucleus of the thalamus, a region that relays proprioceptive information for movement sensation (kinaesthesia). Gait disturbances have been observed with bilateral Vim DBS, but the long-term effects on proprioceptive processing are unknown. We aimed to determine whether Vim DBS surgical implantation or stimulation leads to proprioceptive deficits in the upper limb. We assessed two groups of tremor subjects on measures of proprioception (kinaesthesia, position sense) and motor function using a robotic exoskeleton. In the first group (Surgery), we tested patients before and after implantation of Vim DBS, but before DBS was turned on to determine if proprioceptive deficits were inherent to tremor or caused by DBS implantation. In the second group (Stim), we tested subjects with chronically implanted Vim DBS ON and OFF stimulation. Compared to controls, there were no proprioceptive deficits before or after DBS implantation in the Surgery group. Surprisingly, those that received chronic long-term stimulation (LT-stim, 3–10 years) displayed significant proprioceptive deficits ON and OFF stimulation not present in subjects with chronic short-term stimulation (ST-stim, 0.5–2 years). LT-stim had significantly larger variability and reduced workspace area during the position sense assessment. During the kinesthetic assessment, LT-stim made significantly larger directional errors and consistently underestimated the speed of the robot, despite generating normal movement speeds during motor assessment. Chronic long-term Vim DBS may potentially disrupt proprioceptive processing, possibly inducing irreversible plasticity in the Vim nucleus and/or its network connections. Our findings in the upper limb may help explain some of the gait disturbances seen by others following Vim DBS.</p>
</abstract>
<kwd-group>
<kwd>proprioception</kwd>
<kwd>tremor</kwd>
<kwd>deep brain stimulation (DBS)</kwd>
<kwd>kinesthesia</kwd>
<kwd>position sense</kwd>
<kwd>sensorimotor</kwd>
</kwd-group>
<counts>
<fig-count count="7"></fig-count>
<table-count count="2"></table-count>
<equation-count count="0"></equation-count>
<ref-count count="45"></ref-count>
<page-count count="13"></page-count>
<word-count count="8225"></word-count>
</counts>
</article-meta>
</front>
</pmc>
<affiliations>
<list>
<country>
<li>Canada</li>
<li>États-Unis</li>
</country>
</list>
<tree>
<country name="Canada">
<noRegion>
<name sortKey="Semrau, Jennifer A" sort="Semrau, Jennifer A" uniqKey="Semrau J" first="Jennifer A." last="Semrau">Jennifer A. Semrau</name>
</noRegion>
<name sortKey="Dukelow, Sean P" sort="Dukelow, Sean P" uniqKey="Dukelow S" first="Sean P." last="Dukelow">Sean P. Dukelow</name>
<name sortKey="Dukelow, Sean P" sort="Dukelow, Sean P" uniqKey="Dukelow S" first="Sean P." last="Dukelow">Sean P. Dukelow</name>
<name sortKey="Kiss, Zelma H" sort="Kiss, Zelma H" uniqKey="Kiss Z" first="Zelma H." last="Kiss">Zelma H. Kiss</name>
<name sortKey="Kiss, Zelma H" sort="Kiss, Zelma H" uniqKey="Kiss Z" first="Zelma H." last="Kiss">Zelma H. Kiss</name>
<name sortKey="Semrau, Jennifer A" sort="Semrau, Jennifer A" uniqKey="Semrau J" first="Jennifer A." last="Semrau">Jennifer A. Semrau</name>
</country>
<country name="États-Unis">
<noRegion>
<name sortKey="Herter, Troy M" sort="Herter, Troy M" uniqKey="Herter T" first="Troy M." last="Herter">Troy M. Herter</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>

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