Changes in handwriting resulting from bilateral high-frequency stimulation of the subthalamic nucleus in Parkinson's disease.
Identifieur interne : 000157 ( Ncbi/Curation ); précédent : 000156; suivant : 000158Changes in handwriting resulting from bilateral high-frequency stimulation of the subthalamic nucleus in Parkinson's disease.
Auteurs : H R Siebner [Allemagne] ; A. Ceballos-Baumann ; H. Standhardt ; C. Auer ; B. Conrad ; F. AleschSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 1999.
English descriptors
- KwdEn :
- Aged, Dominance, Cerebral (physiology), Electric Stimulation Therapy (instrumentation), Female, Handwriting, Humans, Male, Middle Aged, Motor Skills (physiology), Parkinson Disease (physiopathology), Parkinson Disease (therapy), Prostheses and Implants, Subthalamic Nucleus (physiopathology), Treatment Outcome.
- MESH :
- instrumentation : Electric Stimulation Therapy.
- physiology : Dominance, Cerebral, Motor Skills.
- physiopathology : Parkinson Disease, Subthalamic Nucleus.
- therapy : Parkinson Disease.
- Aged, Female, Handwriting, Humans, Male, Middle Aged, Prostheses and Implants, Treatment Outcome.
Abstract
High-frequency stimulation of the subthalamic nucleus (STN) is a promising therapeutic approach in patients with severely disabling Parkinson's disease (PD). Whereas STN stimulation improves the cardinal signs of PD, little is known about the effects of STN stimulation on fine manual skills like handwriting. Therefore, the present study investigated the changes in handwriting during bilateral STN stimulation in 12 patients with advanced PD. Dopaminergic medication was discontinued at least 12 hours before the study. The patients were asked to write a standardized sentence repetitively. Five samples of the patient's script were recorded during effective bilateral STN stimulation and 1 hour after both stimulators had been switched off. The movements of the tip of the pencil were recorded using a digitizing tablet. Handwriting movements were segmented into subsequent up- and down-strokes, and a stroke-based kinematic analysis of handwriting was performed. During high-frequency STN stimulation, handwriting movements became faster and smoother indicating a partial restoration of an "open-loop" automatic performance. In addition, STN stimulation gave rise to a significant increase in the mean vertical stroke length demonstrating a stimulation-related reduction in micrographia. The present data underscores the importance of the STN in "open-loop" performance of highly skilled sequential hand movements.
PubMed: 10584671
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Ceballos-Baumann</name></author><author><name sortKey="Standhardt, H" sort="Standhardt, H" uniqKey="Standhardt H" first="H" last="Standhardt">H. Standhardt</name></author><author><name sortKey="Auer, C" sort="Auer, C" uniqKey="Auer C" first="C" last="Auer">C. Auer</name></author><author><name sortKey="Conrad, B" sort="Conrad, B" uniqKey="Conrad B" first="B" last="Conrad">B. Conrad</name></author><author><name sortKey="Alesch, F" sort="Alesch, F" uniqKey="Alesch F" first="F" last="Alesch">F. Alesch</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="ISSN">0885-3185</idno><imprint><date when="1999" type="published">1999</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Dominance, Cerebral (physiology)</term><term>Electric Stimulation Therapy (instrumentation)</term><term>Female</term><term>Handwriting</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Motor Skills (physiology)</term><term>Parkinson Disease (physiopathology)</term><term>Parkinson Disease (therapy)</term><term>Prostheses and Implants</term><term>Subthalamic Nucleus (physiopathology)</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" qualifier="instrumentation" xml:lang="en"><term>Electric Stimulation Therapy</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Dominance, Cerebral</term><term>Motor Skills</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Parkinson Disease</term><term>Subthalamic Nucleus</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Female</term><term>Handwriting</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Prostheses and Implants</term><term>Treatment Outcome</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">High-frequency stimulation of the subthalamic nucleus (STN) is a promising therapeutic approach in patients with severely disabling Parkinson's disease (PD). Whereas STN stimulation improves the cardinal signs of PD, little is known about the effects of STN stimulation on fine manual skills like handwriting. Therefore, the present study investigated the changes in handwriting during bilateral STN stimulation in 12 patients with advanced PD. Dopaminergic medication was discontinued at least 12 hours before the study. The patients were asked to write a standardized sentence repetitively. Five samples of the patient's script were recorded during effective bilateral STN stimulation and 1 hour after both stimulators had been switched off. The movements of the tip of the pencil were recorded using a digitizing tablet. Handwriting movements were segmented into subsequent up- and down-strokes, and a stroke-based kinematic analysis of handwriting was performed. During high-frequency STN stimulation, handwriting movements became faster and smoother indicating a partial restoration of an "open-loop" automatic performance. 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