Changes in handwriting resulting from bilateral high-frequency stimulation of the subthalamic nucleus in Parkinson's disease.
Mov Disord
; 14(6): 964-71, 1999 Nov.
Article
en En
| MEDLINE
| ID: mdl-10584671
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.
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Bases de datos:
MEDLINE
Asunto principal:
Enfermedad de Parkinson
/
Prótesis e Implantes
/
Terapia por Estimulación Eléctrica
/
Núcleo Subtalámico
/
Escritura Manual
Tipo de estudio:
Guideline
Idioma:
En
Revista:
Mov Disord
Año:
1999
Tipo del documento:
Article
País de afiliación:
Alemania