Lagerweij, S.A.J.E.A. (2020) Co-contractions as a predictor of subthalamic nucleus deep brain stimulation efficacy in Parkinson's disease patients. thesis, Medicine.
Full text available on request.Abstract
Background: Deep brain stimulation of the subthalamic nucleus (STN-DBS) is an established treatment option for advanced Parkinson’s disease (PD). However, the clinical outcome after implantation displays variability. This study is aimed at improving clinical outcome and efficacy of STN-DBS for PD by exploring coherence of antagonist muscles during “co-contractions” as a novel biomarker. Co-contractions are related to the core PD symptom of rigidity. It was hypothesized that high pre-DBS coherence would predict improved clinical outcome of DBS. Methods: The bilateral flexor/extensor and biceps/triceps muscle pairs of 22 PD patients who received STN-DBS were recorded by electromyography (EMG). Subsequently, these recordings were analyzed using coherence analysis. Clinical outcome was quantified using the Movement Disorders Society Unified Parkinson’s Disease Rating Scale part III (MDS-UPDRS III). Patients were seen one day prior to DBS surgery (pre-DBS), as well as six months afterwards (post-DBS). Pearson and Spearman’s rho correlations were performed to explore the relation of coherence and clinical outcome. Results: Pre-DBS coherence of individual muscle pairs was significantly correlated to clinical outcome (p<0.01, R=0.672). Furthermore, grouping of pre-DBS coherence in the muscle pairs of the right body side lead to a significant correlation with clinical outcome (p<0.01, R=0.742). Delta (pre-DBS minus post-DBS) coherence as well as post-DBS coherence were significantly correlated to clinical outcome as well (p<0.01, R=0.647; p=0.033, R=0.503). Conclusion: Pre-DBS coherence appeared to be a predictor of STN-DBS clinical outcome. Delta coherence affirmed pathogenicity of this biomarker. Post-DBS coherence showed promising properties for DBS adaptation
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Prof. dr. de Koning-Tijssen, M.A.J. and Dr. Elting, J.W.J. and Drs. van Zijl, J.C. |
| Faculty: | Medical Sciences |
| Date Deposited: | 15 Apr 2024 11:12 |
| Last Modified: | 15 Apr 2024 11:12 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3739 |
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