title: Movement kinematic after deep brain stimulation associated microlesions.
abstract: BACKGROUND
  Deep brain stimulation is widely used for the treatment of movement disorders such as Parkinson's disease and dystonia. After the implantation of electrodes an immediate improvement of clinical symptoms has been described. It is unclear, whether movement kinematics are also changed by this 'microlesion effect'.
  
  
  METHODS
  To gain further insight into these mechanisms, we studied arm, hand and finger movements preoperatively and immediately after the implantation of deep brain stimulation electrodes in patients with Parkinson's disease and dystonia.
  
  
  RESULTS
  After implantation and without stimulation there was a clear reduction of clinical symptoms in both groups, as has been described previously. However, movement velocity was affected differently. Parkinsonian patients showed increased movement velocity postoperatively, whereas dystonic patients were significantly slower after electrode implantation.
  
  
  CONCLUSIONS
  Lesioning and stimulation of these structures have the same beneficial clinical effects. Furthermore we suggest that globus pallidus internum lesions act by inhibiting a system which mainly acts upon muscular tone and limb posture whereas subthalamic stimulation or lesion causes a more unspecific disinhibition of movements.
authors.affiliation: Department of Neurology, Klinikum Großhadern, Ludwig-Maximilian University, Marchioninistr. 15, 81377 Munich, Germany.
authors.forename: Arun
authors.initials: A
authors.lastname: Singh
authors.forename: Stefan
authors.initials: S
authors.lastname: Kammermeier
authors.forename: Jan Hinnerk
authors.initials: JH
authors.lastname: Mehrkens
authors.forename: Kai
authors.initials: K
authors.lastname: Bötzel
mesh_terms: D000368:Aged; D001696:Biomechanical Phenomena; D046690:Deep Brain Stimulation; D004421:Dystonia / Q000503:physiopathology / Q000628:therapy*; D004567:Electrodes, Implanted; D005260:Female; D005917:Globus Pallidus; D006801:Humans; D008297:Male; D008875:Middle Aged; D009048:Motor Skills; D009068:Movement; D009129:Muscle Tonus; D010300:Parkinson Disease / Q000503:physiopathology / Q000628:therapy*; D011187:Posture; D020531:Subthalamic Nucleus