PDF(Pubmed)
Abstract：
BACKGROUND: The current approach to assessing bradykinesia in Parkinson\'s Disease relies on the Unified Parkinson\'s Disease Rating Scale (UPDRS), which is a numeric scale. Inertial sensors offer the ability to probe subcomponents of bradykinesia: motor speed, amplitude, and rhythm. Thus, we sought to investigate the differential effects of high-frequency compared to low-frequency subthalamic nucleus (STN) deep brain stimulation (DBS) on these quantified facets of bradykinesia.
METHODS: We recruited advanced Parkinson\'s Disease subjects with a chronic bilateral subthalamic nucleus (STN) DBS implantation to a single-blind stimulation trial where each combination of medication state (OFF/ON), electrode contacts, and stimulation frequency (60 Hz/180 Hz) was assessed. The Kinesia One sensor system was used to measure upper limb bradykinesia. For each stimulation trial, subjects performed extremity motor tasks. Sensor data were recorded continuously. We identified STN DBS parameters that were associated with improved upper extremity bradykinesia symptoms using a mixed linear regression model.
RESULTS: We recruited 22 subjects (6 females) for this study. The 180 Hz STN DBS (compared to the 60 Hz STN DBS) and dopaminergic medications improved all subcomponents of upper extremity bradykinesia (motor speed, amplitude, and rhythm). For the motor rhythm subcomponent of bradykinesia, ventral contacts yielded improved symptom improvement compared to dorsal contacts.
CONCLUSIONS: The differential impact of high- and low-frequency STN DBS on the symptoms of bradykinesia may advise programming for these patients but warrants further investigation. Wearable sensors represent a valuable addition to the armamentarium that furthers our ability to conduct objective, quantitative clinical assessments.
METHODS: We recruited advanced Parkinson\'s Disease subjects with a chronic bilateral subthalamic nucleus (STN) DBS implantation to a single-blind stimulation trial where each combination of medication state (OFF/ON), electrode contacts, and stimulation frequency (60 Hz/180 Hz) was assessed. The Kinesia One sensor system was used to measure upper limb bradykinesia. For each stimulation trial, subjects performed extremity motor tasks. Sensor data were recorded continuously. We identified STN DBS parameters that were associated with improved upper extremity bradykinesia symptoms using a mixed linear regression model.
RESULTS: We recruited 22 subjects (6 females) for this study. The 180 Hz STN DBS (compared to the 60 Hz STN DBS) and dopaminergic medications improved all subcomponents of upper extremity bradykinesia (motor speed, amplitude, and rhythm). For the motor rhythm subcomponent of bradykinesia, ventral contacts yielded improved symptom improvement compared to dorsal contacts.
CONCLUSIONS: The differential impact of high- and low-frequency STN DBS on the symptoms of bradykinesia may advise programming for these patients but warrants further investigation. Wearable sensors represent a valuable addition to the armamentarium that furthers our ability to conduct objective, quantitative clinical assessments.
摘要：
背景：当前评估帕金森病运动迟缓的方法依赖于统一的帕金森病评分量表（UPDRS），这是一个数字刻度。惯性传感器提供探测运动迟缓子组件的能力：电机速度，振幅,和节奏。因此，我们试图研究高频与低频丘脑下核(STN)深部脑刺激(DBS)对运动迟缓这些量化方面的不同影响.
方法：我们招募了患有慢性双侧丘脑底核（STN）DBS植入的晚期帕金森病受试者，进行单盲刺激试验，其中每种药物状态组合（OFF/ON），电极触点，和刺激频率（60Hz/180Hz）进行评估。运动动力学一传感器系统用于测量上肢运动迟缓。对于每个刺激试验，受试者执行肢体运动任务。连续记录传感器数据。我们使用混合线性回归模型确定了与上肢运动迟缓症状改善相关的STNDBS参数。
结果：本研究招募了22名受试者（6名女性）。180HzSTNDBS（与60HzSTNDBS相比）和多巴胺能药物改善了上肢运动迟缓的所有子组件（运动速度，振幅,和节奏）。对于运动迟缓的运动节律亚组分，与背侧接触相比，腹侧接触症状改善。
结论：高频和低频STNDBS对运动迟缓症状的不同影响可能建议对这些患者进行编程，但值得进一步研究。可穿戴式传感器代表了一个宝贵的补充，以提高我们进行客观，定量临床评估。
方法：我们招募了患有慢性双侧丘脑底核（STN）DBS植入的晚期帕金森病受试者，进行单盲刺激试验，其中每种药物状态组合（OFF/ON），电极触点，和刺激频率（60Hz/180Hz）进行评估。运动动力学一传感器系统用于测量上肢运动迟缓。对于每个刺激试验，受试者执行肢体运动任务。连续记录传感器数据。我们使用混合线性回归模型确定了与上肢运动迟缓症状改善相关的STNDBS参数。
结果：本研究招募了22名受试者（6名女性）。180HzSTNDBS（与60HzSTNDBS相比）和多巴胺能药物改善了上肢运动迟缓的所有子组件（运动速度，振幅,和节奏）。对于运动迟缓的运动节律亚组分，与背侧接触相比，腹侧接触症状改善。
结论：高频和低频STNDBS对运动迟缓症状的不同影响可能建议对这些患者进行编程，但值得进一步研究。可穿戴式传感器代表了一个宝贵的补充，以提高我们进行客观，定量临床评估。
