Intermuscular coherence as a biomarker of subthalamic nucleus deep brain stimulation efficacy in Parkinson's disease

S A J E A Lagerweij; J C van Zijl; T van Laar; D L M Oterdoom; J M C van Dijk; M A J Tijssen; J W Elting

doi:10.1016/j.clinph.2022.07.489

Intermuscular coherence as a biomarker of subthalamic nucleus deep brain stimulation efficacy in Parkinson's disease

Clin Neurophysiol. 2022 Oct:142:36-43. doi: 10.1016/j.clinph.2022.07.489. Epub 2022 Jul 26.

Authors

S A J E A Lagerweij¹, J C van Zijl², T van Laar³, D L M Oterdoom⁴, J M C van Dijk⁴, M A J Tijssen², J W Elting⁵

Affiliations

¹ Department of Neurology, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, 9700 RB Groningen, the Netherlands; UMCG Expertise Center Movement Disorders Groningen, University Medical Center Groningen (UMCG), Hanzeplein 1, 9700 RB Groningen, the Netherlands. Electronic address: s.a.j.e.a.lagerweij@umcg.nl.
² Department of Neurology, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, 9700 RB Groningen, the Netherlands; UMCG Expertise Center Movement Disorders Groningen, University Medical Center Groningen (UMCG), Hanzeplein 1, 9700 RB Groningen, the Netherlands.
³ Department of Neurology, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, 9700 RB Groningen, the Netherlands.
⁴ Department of Neurosurgery, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, 9700 RB Groningen, the Netherlands.
⁵ Department of Neurology, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, 9700 RB Groningen, the Netherlands; Department of Clinical Neurophysiology, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, 9700 RB Groningen, the Netherlands.

PMID: 35963183
DOI: 10.1016/j.clinph.2022.07.489

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.

Keywords: Biomarker; DBS; EMG; Neurophysiology; PD; Parkinson’s disease; STN-DBS; aDBS.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Biomarkers
Deep Brain Stimulation*
Humans
Parkinson Disease* / complications
Parkinson Disease* / diagnosis
Parkinson Disease* / therapy
Subthalamic Nucleus*
Treatment Outcome

Substances

Biomarkers