Intermuscular coherence as biomarker for pallidal deep brain stimulation efficacy in dystonia

E Doldersum; J C van Zijl; M Beudel; H Eggink; R Brandsma; D Piña-Fuentes; M E van Egmond; D L M Oterdoom; J M C van Dijk; J W J Elting; M A J Tijssen

doi:10.1016/j.clinph.2019.04.717

Intermuscular coherence as biomarker for pallidal deep brain stimulation efficacy in dystonia

Clin Neurophysiol. 2019 Aug;130(8):1351-1357. doi: 10.1016/j.clinph.2019.04.717. Epub 2019 May 28.

Authors

Affiliations

¹ Department of Neurology, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, 9700 RB Groningen, the Netherlands.
² Department of Neurology, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, 9700 RB Groningen, the Netherlands; Department of Neurology, Amsterdam Neuroscience Institute, Amsterdam University Medical Center, De Boelelaan 1085, 1081 HV Amsterdam, the Netherlands.
³ Department of Neurology, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, 9700 RB Groningen, the Netherlands; Department of Neurosurgery, 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.
⁶ Department of Neurology, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, 9700 RB Groningen, the Netherlands. Electronic address: m.a.j.de.koning-tijssen@umcg.nl.

PMID: 31207566
DOI: 10.1016/j.clinph.2019.04.717

Abstract

Objective: Finding a non-invasive biomarker for Globus Pallidus interna Deep Brain Stimulation (GPi-DBS) efficacy. Dystonia heterogeneity leads to a wide variety of clinical response to GPi-DBS, making it hard to predict GPi-DBS efficacy for individual patients.

Methods: EEG-EMG recordings of twelve dystonia patients who received bilateral GPi-DBS took place pre- and 1 year post-surgery ON and OFF stimulation, during a rest, pinch, and flexion task. Dystonia severity was assessed using the BFMDRS and TWSTRS (pre- and post-surgery ON stimulation). Intermuscular coherence (IMC) and motorcortex corticomuscular coherence (CMC) were calculated. Low frequency (4-12 Hz) and beta band (13-30 Hz) peak coherences were studied.

Results: Dystonia severity improved after 1 year GPi-DBS therapy (BFMDRS: 30%, median 7.8 (IQR 3-10), TWSTRS: 22%, median 6.8 (IQR 4-9)). 86% of IMC were above the 95% confidence limit. The highest IMC peak decreased significantly with GPi-DBS in the low frequency and beta band. Low frequency and beta band IMC correlated partly with dystonia severity and severity improvement. CMC generally were below the 95% confidence limit.

Conclusions: Peak low frequency IMC functioned as biomarker for GPi-DBS efficacy, and partly correlated with dystonia severity.

Significance: IMC can function as biomarker. Confirmation in a larger study is needed for use in clinical practice.

Keywords: Biomarker; Deep brain stimulation; Dystonia; Intermuscular coherence.

Publication types

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

MeSH terms

Adult
Deep Brain Stimulation / methods*
Dystonia / diagnosis
Dystonia / therapy*
Electroencephalography / methods
Electromyography / methods
Female
Globus Pallidus / physiopathology*
Humans
Male
Middle Aged
Motor Cortex / physiopathology
Muscle, Skeletal / physiopathology*