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Disruption in proprioception from long-term thalamic deep brain stimulation: a pilot study
Deep brain stimulation (DBS) is an excellent treatment for tremor and is generally thought to be reversible by turning off stimulation. For tremor, DBS is implanted in the ventrointermedius (Vim) nucleus of the thalamus, a region that relays proprioceptive information for movement sensation (kinaest...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4416461/ https://www.ncbi.nlm.nih.gov/pubmed/25983689 http://dx.doi.org/10.3389/fnhum.2015.00244 |
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author | Semrau, Jennifer A. Herter, Troy M. Kiss, Zelma H. Dukelow, Sean P. |
author_facet | Semrau, Jennifer A. Herter, Troy M. Kiss, Zelma H. Dukelow, Sean P. |
author_sort | Semrau, Jennifer A. |
collection | PubMed |
description | Deep brain stimulation (DBS) is an excellent treatment for tremor and is generally thought to be reversible by turning off stimulation. For tremor, DBS is implanted in the ventrointermedius (Vim) nucleus of the thalamus, a region that relays proprioceptive information for movement sensation (kinaesthesia). Gait disturbances have been observed with bilateral Vim DBS, but the long-term effects on proprioceptive processing are unknown. We aimed to determine whether Vim DBS surgical implantation or stimulation leads to proprioceptive deficits in the upper limb. We assessed two groups of tremor subjects on measures of proprioception (kinaesthesia, position sense) and motor function using a robotic exoskeleton. In the first group (Surgery), we tested patients before and after implantation of Vim DBS, but before DBS was turned on to determine if proprioceptive deficits were inherent to tremor or caused by DBS implantation. In the second group (Stim), we tested subjects with chronically implanted Vim DBS ON and OFF stimulation. Compared to controls, there were no proprioceptive deficits before or after DBS implantation in the Surgery group. Surprisingly, those that received chronic long-term stimulation (LT-stim, 3–10 years) displayed significant proprioceptive deficits ON and OFF stimulation not present in subjects with chronic short-term stimulation (ST-stim, 0.5–2 years). LT-stim had significantly larger variability and reduced workspace area during the position sense assessment. During the kinesthetic assessment, LT-stim made significantly larger directional errors and consistently underestimated the speed of the robot, despite generating normal movement speeds during motor assessment. Chronic long-term Vim DBS may potentially disrupt proprioceptive processing, possibly inducing irreversible plasticity in the Vim nucleus and/or its network connections. Our findings in the upper limb may help explain some of the gait disturbances seen by others following Vim DBS. |
format | Online Article Text |
id | pubmed-4416461 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-44164612015-05-15 Disruption in proprioception from long-term thalamic deep brain stimulation: a pilot study Semrau, Jennifer A. Herter, Troy M. Kiss, Zelma H. Dukelow, Sean P. Front Hum Neurosci Neuroscience Deep brain stimulation (DBS) is an excellent treatment for tremor and is generally thought to be reversible by turning off stimulation. For tremor, DBS is implanted in the ventrointermedius (Vim) nucleus of the thalamus, a region that relays proprioceptive information for movement sensation (kinaesthesia). Gait disturbances have been observed with bilateral Vim DBS, but the long-term effects on proprioceptive processing are unknown. We aimed to determine whether Vim DBS surgical implantation or stimulation leads to proprioceptive deficits in the upper limb. We assessed two groups of tremor subjects on measures of proprioception (kinaesthesia, position sense) and motor function using a robotic exoskeleton. In the first group (Surgery), we tested patients before and after implantation of Vim DBS, but before DBS was turned on to determine if proprioceptive deficits were inherent to tremor or caused by DBS implantation. In the second group (Stim), we tested subjects with chronically implanted Vim DBS ON and OFF stimulation. Compared to controls, there were no proprioceptive deficits before or after DBS implantation in the Surgery group. Surprisingly, those that received chronic long-term stimulation (LT-stim, 3–10 years) displayed significant proprioceptive deficits ON and OFF stimulation not present in subjects with chronic short-term stimulation (ST-stim, 0.5–2 years). LT-stim had significantly larger variability and reduced workspace area during the position sense assessment. During the kinesthetic assessment, LT-stim made significantly larger directional errors and consistently underestimated the speed of the robot, despite generating normal movement speeds during motor assessment. Chronic long-term Vim DBS may potentially disrupt proprioceptive processing, possibly inducing irreversible plasticity in the Vim nucleus and/or its network connections. Our findings in the upper limb may help explain some of the gait disturbances seen by others following Vim DBS. Frontiers Media S.A. 2015-05-01 /pmc/articles/PMC4416461/ /pubmed/25983689 http://dx.doi.org/10.3389/fnhum.2015.00244 Text en Copyright © 2015 Semrau, Herter, Kiss and Dukelow. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neuroscience Semrau, Jennifer A. Herter, Troy M. Kiss, Zelma H. Dukelow, Sean P. Disruption in proprioception from long-term thalamic deep brain stimulation: a pilot study |
title | Disruption in proprioception from long-term thalamic deep brain stimulation: a pilot study |
title_full | Disruption in proprioception from long-term thalamic deep brain stimulation: a pilot study |
title_fullStr | Disruption in proprioception from long-term thalamic deep brain stimulation: a pilot study |
title_full_unstemmed | Disruption in proprioception from long-term thalamic deep brain stimulation: a pilot study |
title_short | Disruption in proprioception from long-term thalamic deep brain stimulation: a pilot study |
title_sort | disruption in proprioception from long-term thalamic deep brain stimulation: a pilot study |
topic | Neuroscience |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4416461/ https://www.ncbi.nlm.nih.gov/pubmed/25983689 http://dx.doi.org/10.3389/fnhum.2015.00244 |
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