title: Subthalamic deep brain stimulation and dopaminergic medication in Parkinson's disease: Impact on inter-limb coupling.
abstract: Patients with Parkinson's disease (PD) often present with bimanual coordination deficits whose exact origins remain unclear. One aspect of bimanual coordination is inter-limb coupling. This is characterized by the harmonization of movement parameters between limbs. We assessed different aspects of bimanual coordination in patients with PD, including inter-limb coupling, and determined whether they are altered by subthalamic (STN) deep brain stimulation (DBS) or dopaminergic medication. Twenty PD patients were tested before STN DBS surgery; with and without medication. Post- surgery, patients were tested with their stimulators on and off as well as with and without medication. Patients were asked to perform a unimanual and bimanual rapid repetitive diadochokinesis task. The difference in mean amplitude and mean duration of cycles between hands was computed in order to assess inter-limb coupling. Also, mean angular velocity of both hands and structural coupling were computed for the bimanual task. There was a positive effect of medication and stimulation on mean angular velocity, which relates to clinical improvement. PD patients exhibited temporal inter-limb coupling that was not altered by either medication or STN stimulation. However, PD patients did not exhibit spatial inter-limb coupling. Again, this was not altered by medication or stimulation. Collectively, the results suggest that structures independent of the dopaminergic system and basal ganglia may mediate temporal and spatial inter-limb coupling.
authors: Cone Laboratory for Research in Neurosurgery, Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Motion Analysis Laboratory of Spaulding Rehabilitation Hospital, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA; Laboratoire d'évaluation des troubles du mouvement, Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada.
authors: Jean-François
authors: JF
authors: Daneault
authors: Laboratoire d'évaluation des troubles du mouvement, Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada; Département de Sciences Biologiques, Université du Québec à Montréal, Montréal, Québec, Canada.
authors: Benoit
authors: B
authors: Carignan
authors: Cone Laboratory for Research in Neurosurgery, Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada.
authors: Abbas F
authors: AF
authors: Sadikot
authors: Laboratoire d'évaluation des troubles du mouvement, Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada; Département de Sciences Biologiques, Université du Québec à Montréal, Montréal, Québec, Canada; Département des Sciences de l'Activité Physique, Université du Québec à Montréal, Montréal, Québec, Canada. Electronic address: duval.christian@uqam.ca.
authors: Christian
authors: C
authors: Duval
mesh_terms: D000328:Adult; D000368:Aged; D001479:Basal Ganglia / Q000187:drug effects; D046690:Deep Brain Stimulation / Q000379:methods; D015259:Dopamine Agents / Q000494:pharmacology*; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D008875:Middle Aged; D009068:Movement / Q000187:drug effects*; D010300:Parkinson Disease / Q000503:physiopathology* / Q000628:therapy; D020531:Subthalamic Nucleus / Q000502:physiology / Q000503:physiopathology
chemical_list: D015259:Dopamine Agents
keywords: DBS; Parkinson; STN; bimanual; diadochokinesia; rapid alternating movement