H-H Capelle has received speaker's honoraria from Medtronic.
Rapid response of parkinsonian tremor to STN-DBS changes: Direct modulation of oscillatory basal ganglia activity?
Article first published online: 1 MAY 2009
Copyright © 2009 Movement Disorder Society
Volume 24, Issue 8, pages 1221–1225, 15 June 2009
How to Cite
Blahak, C., Bäzner, H., Capelle, H.-H., Wöhrle, J. C., Weigel, R., Hennerici, M. G. and Krauss, J. K. (2009), Rapid response of parkinsonian tremor to STN-DBS changes: Direct modulation of oscillatory basal ganglia activity?. Mov. Disord., 24: 1221–1225. doi: 10.1002/mds.22536
- Issue published online: 18 JUN 2009
- Article first published online: 1 MAY 2009
- Manuscript Accepted: 12 FEB 2009
- Manuscript Revised: 10 FEB 2009
- Manuscript Received: 5 AUG 2008
- Parkinson's disease;
- deep brain stimulation;
- subthalamic nucleus
Although deep brain stimulation (DBS) of the subthalamic nucleus (STN) has proved to be effective for tremor and other cardinal symptoms in Parkinson's disease (PD), the precise mechanisms of action of DBS are still unclear. We analyzed the time course of resting tremor amplitude and frequency during discontinuation and subsequent reinitiation of STN-DBS in nine PD patients, using a computerized three-dimensional motion analysis combined with surface electromyography. Following discontinuation of STN-DBS, resting tremor amplitude rapidly increased, reaching maximum amplitude after 2 min (mean ± 95%CI: 34.3 ± 13.8 mm; P < 0.01), subsequently stabilizing at a medium level. Reinitiation of stimulation after 30 min resulted in rapid, nearly complete suppression of tremor activity within 1 min (1.4 ± 1.3 mm; P < 0.01) and, furthermore, increased tremor frequency within a few seconds in seven of nine patients. These findings support the hypothesis that STN-DBS acts by direct interference with the neurotransmission of basal ganglia networks involved in tremor. © 2009 Movement Disorder Society