Levodopa-Induced Changes in Electromyographic Patterns in Patients with Advanced Parkinson's Disease

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http://hdl.handle.net/10138/233477

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Ruonala , V , Pekkonen , E , Airaksinen , O , Kankaanpää , M , Karjalainen , P A & Rissanen , S M 2018 , ' Levodopa-Induced Changes in Electromyographic Patterns in Patients with Advanced Parkinson's Disease ' , Frontiers in neurology , vol. 9 , 35 . https://doi.org/10.3389/fneur.2018.00035

Title: Levodopa-Induced Changes in Electromyographic Patterns in Patients with Advanced Parkinson's Disease
Author: Ruonala, Verneri; Pekkonen, Eero; Airaksinen, Olavi; Kankaanpää, Markku; Karjalainen, Pasi A.; Rissanen, Saara M.
Contributor organization: Department of Neurosciences
Clinicum
Neurologian yksikkö
University of Helsinki
HUS Medical Imaging Center
Date: 2018-02-05
Language: eng
Number of pages: 8
Belongs to series: Frontiers in neurology
ISSN: 1664-2295
DOI: https://doi.org/10.3389/fneur.2018.00035
URI: http://hdl.handle.net/10138/233477
Abstract: Levodopa medication is the most efficient treatment for motor symptoms of Parkinson's disease (PD). Levodopa significantly alleviates rigidity, rest tremor, and bradykinesia in PD. The severity of motor symptoms can be graded with UPDRS-III scale. Levodopa challenge test is routinely used to assess patients' eligibility to deep-brain stimulation (DBS) in PD. Feasible and objective measurements to assess motor symptoms of PD during levodopa challenge test would be helpful in unifying the treatment. Twelve patients with advanced PD who were candidates for DBS treatment were recruited to the study. Measurements were done in four phases before and after levodopa challenge test. Rest tremor and rigidity were evaluated using UPDRS-III score. Electromyographic (EMG) signals from biceps brachii and kinematic signals from forearm were recorded with wireless measurement setup. The patients performed two different tasks: arm isometric tension and arm passive flexion-extension. The electromyographic and the kinematic signals were analyzed with parametric, principal component, and spectrum-based approaches. The principal component approach for isometric tension EMG signals showed significant decline in characteristics related to PD during levodopa challenge test. The spectral approach on passive flexion-extension EMG signals showed a significant decrease on involuntary muscle activity during the levodopa challenge test. Both effects were stronger during the levodopa challenge test compared to that of patients' personal medication. There were no significant changes in the parametric approach for EMG and kinematic signals during the measurement. The results show that a wireless and wearable measurement and analysis can be used to study the effect of levodopa medication in advanced Parkinson's disease.
Subject: Parkinson's disease
levodopa challenge test
medication
EMG
kinematic
wearable
PCA
DEEP BRAIN-STIMULATION
SUBTHALAMIC NUCLEUS STIMULATION
SURFACE EMG
KINEMATIC PARAMETERS
ESSENTIAL TREMOR
MEDICATION
SIGNALS
BRADYKINESIA
EXTRACTION
FEATURES
3124 Neurology and psychiatry
3112 Neurosciences
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


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