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58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

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Effects of deep brain stimulation in Parkinson's disease quantified by diadochometry

Messung der Effektivität der Tiefenhirnstimulation bei M. Parkinson durch die Diadochometrie

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  • corresponding author A. Harati - Neurochirurgische Klinik, KKH Bochum, Ruhr-Universität Bochum
  • G. Ellrichmann - Neurologische Klinik, St.Josef Hospital, Ruhr-Universität Bochum
  • D. Cyron - Neurochirurgische Klinik, KKH Bochum, Ruhr-Universität Bochum
  • P. Kraus - Neurologische Klinik, St.Josef Hospital, Ruhr-Universität Bochum
  • T. Müller - Neurologische Klinik, St.Josef Hospital, Ruhr-Universität Bochum

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocSO.06.04

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2007/07dgnc249.shtml

Published: April 11, 2007

© 2007 Harati et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: We describe the quantification of bradykinesia and its response to DBS with diadochometry.The effectiveness of deep brain stimulation DBS for the treatment of Parkinsons' disease has been shown in several retrospective and one prospective study. The ratings of these studies however rely on clinical rating scales like the UPDRS as main tools for assessment of motor performance. The limited interrater reliability of these scales impaires the comparison of different studies. Moreover a tool free of the influence of an individual investigator would lend credibility to the merits of DBS. The validity of diadochometry has been demonstrated in previous studies. The parameters measured are movement velocity along with amplitude and frequency of diadochokinesia.

Methods: Rapid alternating forearm supination and pronation was recorded in ten patients with Parkinson’s disease following implantation of electrodes in the STN by a diadochometry device built in our laboratory. The tests were performed in the following treatment conditions: 1 preoperative: medication on/off; 2 postoperative: off stimulation on medication; 3 postoperative: on stimulation on medication. Also, a group of age- and gender-matched control subjects was examined.

Results: DBS increased movement velocity, movement amplitude and movement frequency. The improvement of movement velocity in diadochometry and bradykinesia in UPDRS part III were closely related. The movement velocity of neurological normal control subjects remained significantly higher than the values of patients in the stimulation on condition.

Conclusions: In our study we could quantify preoperative bradykinesia and its significant improvement after DBS. Diadochometry values are closely related to UPDRS motorscores. Diadochometry is a valid, objective and simple to perform diagnostic tool. It should be considered as an additional tool besides established clinical rating scales in future trials on the efficacy of DBS.