Simultaneous repetitive movements following pallidotomy or subthalamic deep brain stimulation in patients with Parkinson's disease.
Identifieur interne : 001432 ( PubMed/Checkpoint ); précédent : 001431; suivant : 001433Simultaneous repetitive movements following pallidotomy or subthalamic deep brain stimulation in patients with Parkinson's disease.
Auteurs : R. Levy [Canada] ; A E Lang ; W D Hutchison ; A M Lozano ; J O DostrovskySource :
- Experimental brain research [ 0014-4819 ] ; 2002.
English descriptors
- KwdEn :
- Aged, Analysis of Variance, Antiparkinson Agents (therapeutic use), Combined Modality Therapy, Electric Stimulation, Female, Functional Laterality, Globus Pallidus (surgery), Humans, Levodopa (therapeutic use), Male, Middle Aged, Movement (physiology), Parkinson Disease (drug therapy), Parkinson Disease (physiopathology), Parkinson Disease (surgery), Psychomotor Performance, Reaction Time, Subthalamic Nucleus (physiopathology), Wrist (physiology).
- MESH :
- chemical , therapeutic use : Antiparkinson Agents, Levodopa.
- drug therapy : Parkinson Disease.
- physiology : Movement, Wrist.
- physiopathology : Parkinson Disease, Subthalamic Nucleus.
- surgery : Globus Pallidus, Parkinson Disease.
- Aged, Analysis of Variance, Combined Modality Therapy, Electric Stimulation, Female, Functional Laterality, Humans, Male, Middle Aged, Psychomotor Performance, Reaction Time.
Abstract
Patients with Parkinson's disease (PD) commonly exhibit difficulties performing simultaneous tasks and levodopa has been shown to improve the performance of these movements to a greater extent than movements performed in isolation. The aim of this study was to compare the effects of acute unilateral pallidal lesions (nine patients) and bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) (eight patients) with levodopa therapy (ten patients) on the performance of isolated versus bilateral simultaneous repetitive movements. The STN group was assessed with and without DBS both on and off levodopa. The two tasks employed were maximally paced button tapping (Tap) and wrist pronation-supination (WPS) movements. During the off drug state (12-14 h after the last oral dose of levodopa), the performance of simultaneous Tap and WPS movements in all three groups was significantly slower and more irregular than when each movement was performed in isolation. For example, WPS velocity decreased by at least 37% (P<0.05) with concomitant Tap. Following levodopa, pallidotomy or STN DBS, WPS velocity was increased during the simultaneous task to a greater extent than in the isolated task. All treatments also improved WPS velocity and increased the regularity of movement during concomitant Tap (P<0.01). The findings indicate that, like levodopa, surgical therapies can improve the performance of simultaneous tasks more than isolated tasks. These observations suggest that the excessive neuronal activity and/or abnormal firing patterns in the globus pallidus internus that is found in parkinsonian patients contribute to difficulties in the execution of complex motor tasks.
DOI: 10.1007/s00221-002-1257-8
PubMed: 12428140
Affiliations:
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Levy</name><affiliation wicri:level="4"><nlm:affiliation>Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, Ontario M5S 1A8, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, Ontario M5S 1A8</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Lang, A E" sort="Lang, A E" uniqKey="Lang A" first="A E" last="Lang">A E Lang</name></author><author><name sortKey="Hutchison, W D" sort="Hutchison, W D" uniqKey="Hutchison W" first="W D" last="Hutchison">W D Hutchison</name></author><author><name sortKey="Lozano, A M" sort="Lozano, A M" uniqKey="Lozano A" first="A M" last="Lozano">A M Lozano</name></author><author><name sortKey="Dostrovsky, J O" sort="Dostrovsky, J O" uniqKey="Dostrovsky J" first="J O" last="Dostrovsky">J O Dostrovsky</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2002">2002</date><idno type="RBID">pubmed:12428140</idno><idno type="pmid">12428140</idno><idno type="doi">10.1007/s00221-002-1257-8</idno><idno type="wicri:Area/PubMed/Corpus">001477</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001477</idno><idno type="wicri:Area/PubMed/Curation">001477</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">001477</idno><idno type="wicri:Area/PubMed/Checkpoint">001477</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">001477</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Simultaneous repetitive movements following pallidotomy or subthalamic deep brain stimulation in patients with Parkinson's disease.</title><author><name sortKey="Levy, R" sort="Levy, R" uniqKey="Levy R" first="R" last="Levy">R. Levy</name><affiliation wicri:level="4"><nlm:affiliation>Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, Ontario M5S 1A8, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, Ontario M5S 1A8</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Lang, A E" sort="Lang, A E" uniqKey="Lang A" first="A E" last="Lang">A E Lang</name></author><author><name sortKey="Hutchison, W D" sort="Hutchison, W D" uniqKey="Hutchison W" first="W D" last="Hutchison">W D Hutchison</name></author><author><name sortKey="Lozano, A M" sort="Lozano, A M" uniqKey="Lozano A" first="A M" last="Lozano">A M Lozano</name></author><author><name sortKey="Dostrovsky, J O" sort="Dostrovsky, J O" uniqKey="Dostrovsky J" first="J O" last="Dostrovsky">J O Dostrovsky</name></author></analytic><series><title level="j">Experimental brain research</title><idno type="ISSN">0014-4819</idno><imprint><date when="2002" type="published">2002</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Analysis of Variance</term><term>Antiparkinson Agents (therapeutic use)</term><term>Combined Modality Therapy</term><term>Electric Stimulation</term><term>Female</term><term>Functional Laterality</term><term>Globus Pallidus (surgery)</term><term>Humans</term><term>Levodopa (therapeutic use)</term><term>Male</term><term>Middle Aged</term><term>Movement (physiology)</term><term>Parkinson Disease (drug therapy)</term><term>Parkinson Disease (physiopathology)</term><term>Parkinson Disease (surgery)</term><term>Psychomotor Performance</term><term>Reaction Time</term><term>Subthalamic Nucleus (physiopathology)</term><term>Wrist (physiology)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiparkinson Agents</term><term>Levodopa</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Movement</term><term>Wrist</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Parkinson Disease</term><term>Subthalamic Nucleus</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Globus Pallidus</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Analysis of Variance</term><term>Combined Modality Therapy</term><term>Electric Stimulation</term><term>Female</term><term>Functional Laterality</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Psychomotor Performance</term><term>Reaction Time</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Patients with Parkinson's disease (PD) commonly exhibit difficulties performing simultaneous tasks and levodopa has been shown to improve the performance of these movements to a greater extent than movements performed in isolation. The aim of this study was to compare the effects of acute unilateral pallidal lesions (nine patients) and bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) (eight patients) with levodopa therapy (ten patients) on the performance of isolated versus bilateral simultaneous repetitive movements. The STN group was assessed with and without DBS both on and off levodopa. The two tasks employed were maximally paced button tapping (Tap) and wrist pronation-supination (WPS) movements. During the off drug state (12-14 h after the last oral dose of levodopa), the performance of simultaneous Tap and WPS movements in all three groups was significantly slower and more irregular than when each movement was performed in isolation. For example, WPS velocity decreased by at least 37% (P<0.05) with concomitant Tap. Following levodopa, pallidotomy or STN DBS, WPS velocity was increased during the simultaneous task to a greater extent than in the isolated task. All treatments also improved WPS velocity and increased the regularity of movement during concomitant Tap (P<0.01). The findings indicate that, like levodopa, surgical therapies can improve the performance of simultaneous tasks more than isolated tasks. These observations suggest that the excessive neuronal activity and/or abnormal firing patterns in the globus pallidus internus that is found in parkinsonian patients contribute to difficulties in the execution of complex motor tasks.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">12428140</PMID><DateCreated><Year>2002</Year><Month>11</Month><Day>12</Day></DateCreated><DateCompleted><Year>2003</Year><Month>03</Month><Day>07</Day></DateCompleted><DateRevised><Year>2013</Year><Month>12</Month><Day>13</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Print">0014-4819</ISSN><JournalIssue CitedMedium="Print"><Volume>147</Volume><Issue>3</Issue><PubDate><Year>2002</Year><Month>Dec</Month></PubDate></JournalIssue><Title>Experimental brain research</Title><ISOAbbreviation>Exp Brain Res</ISOAbbreviation></Journal><ArticleTitle>Simultaneous repetitive movements following pallidotomy or subthalamic deep brain stimulation in patients with Parkinson's disease.</ArticleTitle><Pagination><MedlinePgn>322-31</MedlinePgn></Pagination><Abstract><AbstractText>Patients with Parkinson's disease (PD) commonly exhibit difficulties performing simultaneous tasks and levodopa has been shown to improve the performance of these movements to a greater extent than movements performed in isolation. The aim of this study was to compare the effects of acute unilateral pallidal lesions (nine patients) and bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) (eight patients) with levodopa therapy (ten patients) on the performance of isolated versus bilateral simultaneous repetitive movements. The STN group was assessed with and without DBS both on and off levodopa. The two tasks employed were maximally paced button tapping (Tap) and wrist pronation-supination (WPS) movements. During the off drug state (12-14 h after the last oral dose of levodopa), the performance of simultaneous Tap and WPS movements in all three groups was significantly slower and more irregular than when each movement was performed in isolation. For example, WPS velocity decreased by at least 37% (P<0.05) with concomitant Tap. Following levodopa, pallidotomy or STN DBS, WPS velocity was increased during the simultaneous task to a greater extent than in the isolated task. All treatments also improved WPS velocity and increased the regularity of movement during concomitant Tap (P<0.01). The findings indicate that, like levodopa, surgical therapies can improve the performance of simultaneous tasks more than isolated tasks. These observations suggest that the excessive neuronal activity and/or abnormal firing patterns in the globus pallidus internus that is found in parkinsonian patients contribute to difficulties in the execution of complex motor tasks.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Levy</LastName><ForeName>R</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, Ontario M5S 1A8, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lang</LastName><ForeName>A E</ForeName><Initials>AE</Initials></Author><Author ValidYN="Y"><LastName>Hutchison</LastName><ForeName>W D</ForeName><Initials>WD</Initials></Author><Author ValidYN="Y"><LastName>Lozano</LastName><ForeName>A M</ForeName><Initials>AM</Initials></Author><Author ValidYN="Y"><LastName>Dostrovsky</LastName><ForeName>J O</ForeName><Initials>JO</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016430">Clinical Trial</PublicationType><PublicationType UI="D003160">Comparative Study</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2002</Year><Month>10</Month><Day>12</Day></ArticleDate></Article><MedlineJournalInfo><Country>Germany</Country><MedlineTA>Exp Brain Res</MedlineTA><NlmUniqueID>0043312</NlmUniqueID><ISSNLinking>0014-4819</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000978">Antiparkinson Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>46627O600J</RegistryNumber><NameOfSubstance 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MajorTopicYN="N">Globus Pallidus</DescriptorName><QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007980" MajorTopicYN="N">Levodopa</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009068" MajorTopicYN="N">Movement</DescriptorName><QualifierName UI="Q000502" MajorTopicYN="Y">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D010300" MajorTopicYN="N">Parkinson Disease</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName><QualifierName UI="Q000503" 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PubStatus="pubmed"><Year>2002</Year><Month>11</Month><Day>13</Day><Hour>4</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2003</Year><Month>3</Month><Day>8</Day><Hour>4</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2002</Year><Month>11</Month><Day>13</Day><Hour>4</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">12428140</ArticleId><ArticleId IdType="doi">10.1007/s00221-002-1257-8</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Canada</li></country><region><li>Ontario</li></region><settlement><li>Toronto</li></settlement><orgName><li>Université de Toronto</li></orgName></list><tree><noCountry><name sortKey="Dostrovsky, J O" sort="Dostrovsky, J O" uniqKey="Dostrovsky J" first="J O" last="Dostrovsky">J O Dostrovsky</name><name sortKey="Hutchison, W D" sort="Hutchison, W D" uniqKey="Hutchison W" first="W D" last="Hutchison">W D Hutchison</name><name sortKey="Lang, A E" sort="Lang, A E" uniqKey="Lang A" first="A E" last="Lang">A E Lang</name><name sortKey="Lozano, A M" sort="Lozano, A M" uniqKey="Lozano A" first="A M" last="Lozano">A M Lozano</name></noCountry><country name="Canada"><region name="Ontario"><name sortKey="Levy, R" sort="Levy, R" uniqKey="Levy R" first="R" last="Levy">R. 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