Intermuscular coherence as a biomarker of subthalamic nucleus deep brain stimulation efficacy in Parkinson's disease. (October 2022)

• Record Type: Journal Article
• Authors: Lagerweij, S.A.J.E.A.; van Zijl, J.C.; van Laar, T.; Oterdoom, D.L.M.; van Dijk, J.M.C.; Tijssen, M.A.J.; Elting, J.W.
• Is Part Of: Clinical neurophysiology. Volume 142(2022)
• Page Start: 36
• Page End: 43
• Publication Date: 2022-10
• Subjects: STN-DBS -- DBS -- PD -- Parkinson's disease -- EMG -- Neurophysiology -- Biomarker -- aDBS; STN-DBS subthalamic nucleus deep brain stimulation -- PD Parkinson's Disease -- EMG electromyography -- MDS-UPDRS Movement Disorders Society Unified Parkinson's Disease Rating Scale -- UPDRS-III Unified Parkinson's Disease Rating Scale part III -- GPi globus pallidus interna -- VAS visual analogous scale -- AVG average -- PEAK peak -- AUC area under the curve -- aDBS adaptive deep brain stimulation; Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electromyography -- Periodicals; Neurology -- Periodicals; 612.8
• DOI: 10.1016/j.clinph.2022.07.489
• Languages: English
• ISSNs: 1388-2457

Abstract

Highlights: Patient selection for STN-DBS in PD can be aided by intermuscular coherence. EMG-recordings of intermuscular coherence might be a biomarker for STN-DBS adaptation in PD. Clinical state of PD patients can be objectively assessed using intermuscular coherence. Abstract: Objective: Deep brain stimulation of the subthalamic nucleus (STN-DBS) is an established treatment in advanced Parkinson's disease (PD). However, the clinical outcome after STN-DBS is variable. The aim of this study was to explore the coherence of antagonistic muscles measured with electromyography (EMG) as novel biomarker of STN-DBS efficacy in PD. Methods: EMG of bilateral wrist and upper arm antagonistic muscles of 21 PD patients was recorded during three standardized motor tasks. Patients were measured one day prior to DBS surgery (pre-DBS) and 6 months afterwards (post-DBS). Coherence analyses were performed on the antagonistic muscle pairs. Pearson correlations between intermuscular coherence and clinical performance were calculated. Results: Intermuscular coherence during each of the different co-contraction tasks significantly correlated to UPDRS-III bradykinesia scores ( p < 0.01 ). In other words, higher intermuscular coherence is associated with more severe PD symptoms. Moreover, coherence changes (pre-DBS – post-DBS coherence) correlated to clinical score changes after DBS ( p < 0.01 ) and pre-DBS coherence correlated to this clinical score change as well ( p < 0.01 ). Conclusions: Higher pre-DBS coherence of antagonistic arm muscles is correlated to worsening of clinical PD state and higher intermuscular coherence predicts enhanced clinical improvement. Significance: We propose that pre-DBS intermuscular coherence could be developed into a predictor of STN-DBS clinical outcome. It could aid patient selection and adaptive stimulation algorithms for DBS.