title: Deep brain stimulation amplitude alters posture shift velocity in Parkinson's disease.
abstract: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is now widely used to alleviate symptoms of Parkinson's disease (PD). The specific aim of this study was to identify posture control measures that may be used to improve selection of DBS parameters in the clinic and this was carried out by changing the DBS stimulation amplitude. A dynamic posture shift paradigm was used to assess posture control in 4 PD STN-DBS subjects. Each subject was tested at 4 stimulation amplitude settings. Movements of the center of pressure and the position of the pelvis were monitored and several quantitative indices were calculated. The presence of any statistically significant changes in several normalized indices due to reduced/no stimulation was tested using the one-sample t test. The peak velocity and the average movement velocity during the initial and mid phases of movement towards the target posture were substantially reduced. These results may be explained in terms of increased akinesia and bradykinesia due to altered stimulation conditions. Thus, the dynamic posture shift paradigm may be an effective tool to quantitatively characterize the effects of DBS on posture control and should be further investigated as a tool for selection of DBS parameters in the clinic.
authors.affiliation: Center for Adaptive Neural Systems, School of Biological and Health Systems Engineering, Arizona State University, 1100 East University Drive, Suite 116, Tempe, AZ 85281 USA ; Muhammad Ali Parkinson Center, Barrow Neurological Institute, 240 W. Thomas Road, Ste. 301, Phoenix, AZ 85013 USA.
authors.forename: Narayanan
authors.initials: N
authors.lastname: Krishnamurthi
authors.affiliation: Center for Adaptive Neural Systems, School of Biological and Health Systems Engineering, Arizona State University, 1100 East University Drive, Suite 116, Tempe, AZ 85281 USA.
authors.forename: Stefani
authors.initials: S
authors.lastname: Mulligan
authors.affiliation: Center for Adaptive Neural Systems, School of Biological and Health Systems Engineering, Arizona State University, 1100 East University Drive, Suite 116, Tempe, AZ 85281 USA ; Movement Disorders Clinic, Banner Good Samaritan Medical Center, Phoenix, AZ 85006 USA.
authors.forename: Padma
authors.initials: P
authors.lastname: Mahant
authors.affiliation: Center for Adaptive Neural Systems, School of Biological and Health Systems Engineering, Arizona State University, 1100 East University Drive, Suite 116, Tempe, AZ 85281 USA ; Movement Disorders Clinic, Banner Good Samaritan Medical Center, Phoenix, AZ 85006 USA.
authors.forename: Johan
authors.initials: J
authors.lastname: Samanta
authors.affiliation: Center for Adaptive Neural Systems, School of Biological and Health Systems Engineering, Arizona State University, 1100 East University Drive, Suite 116, Tempe, AZ 85281 USA.
authors.forename: James J
authors.initials: JJ
authors.lastname: Abbas
keywords: Deep brain stimulation; Dynamic posture shifts; Movement velocity; Parkinson’s disease; Posture control