Comparison of Pallidal and Subthalamic Stimulation on Force Control in Patient's with Parkinson's Disease
in Motor ControlClick name to view affiliation
The aim of this study was to determine the effects of unilateral deep brain stimulation (DBS) on the control and coordination of grasping forces produced by Parkinson's disease (PD) patients. Ten advanced PD patients with unilateral DBS in the globus pallidus (GPi) or the subthalamic nucleus (STN) (5 patients in each group) performed a functional bimanual dexterous manipulation task. Experiments were performed in the “Off” medication state with DBS “On” and “Off.” DBS resulted in (a) significant clinical improvements, (b) greater maximum grip force for both limbs, (c) reduced movement time, and (d) bilateral coupling of grasping forces. There were no significant differences between the GPi and STN groups for any clinical or kinematic measures. DBS of the GPi and STN leads to an improvement in the motor functioning of advanced PD patients. Improvement in force-timing specification during DBS might allow PD patients to employ a feedforward method of force control.
Alberts is with the School of Applied Physiology, Georgia Institute of Technology, Atlanta, GA 30332 and the Atlanta VA Rehabilitation and Research Center, Atlanta, GA 30033. Elder and Vitek are with the Dept of Neurology, Emory University, Atlanta, GA 30322. Okun is with the Dept of Neurology, University of Florida, Gainesville, FL 32610.
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