Article (Scientific journals)
Involuntary eyelid closure after STN-DBS: evidence for different pathophysiological entities.
Weiss, Daniel; Wachter, Tobias; Breit, Sorin et al.
2010In Journal of Neurology, Neurosurgery and Psychiatry, 81 (9), p. 1002-7
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Keywords :
Aged; Deep Brain Stimulation/adverse effects/methods; Electromyography/methods; Eyelid Diseases/complications/physiopathology; Eyelids/physiopathology; Female; Humans; Male; Middle Aged; Parkinson Disease/complications/therapy; Pyramidal Tracts/physiopathology; Subthalamic Nucleus/physiopathology
Abstract :
[en] OBJECTIVE: Involuntary eyelid closure (IEC) may occur after deep brain stimulation of the subthalamic nucleus (STN-DBS) in Parkinson's disease (PD) and is often categorised as apraxia of lid opening (ALO), albeit the appropriateness of this term is under debate. To gain insight into the hitherto undefined pathophysiology of IEC after STN-DBS, we performed a comprehensive clinical and electrophysiological characterisation of lid function in a total of six PD patients. METHODS: The study was carried out in six PD patients who developed IEC after STN-DBS. They underwent neurological examination and electromyography recording of activity in the orbicularis oculi muscle (OO) upon varying stimulation patterns. Intraoperative studies were performed in one patient. RESULTS: Increasing STN-DBS intensity induced IEC in four patients, whereas it improved the condition in two. Needle EMG showed tonic hyperactivity of the OO in STN-DBS induced IEC, while variable patterns of OO activity (irregular and tonic) were seen in patients with STN-DBS-relieved IEC. Intraoperative analysis in one patient showed evidence for IEC being induced by activation of corticobulbar fibres. CONCLUSIONS: We identified two groups of IEC after STN-DBS based on clinical and EMG patterns: (1) STN-DBS induced IEC associated with tonic OO overactivity and (2) STN-DBS relieved IEC presenting with variable EMG patterns. Our findings provide relevant information on pathophysiology of STN-DBS related IEC and implications for its therapeutic management.
Research center :
- Luxembourg Centre for Systems Biomedicine (LCSB): Clinical & Experimental Neuroscience (Krüger Group)
Disciplines :
Genetics & genetic processes
Author, co-author :
Weiss, Daniel
Wachter, Tobias
Breit, Sorin
Jacob, Simon N.
Pomper, Jorn K.
Asmus, Friedrich
Valls-Sole, Josep
Plewnia, Christian
Gasser, Thomas
Gharabaghi, Alireza
Krüger, Rejko ;  University of Luxembourg > Faculty of Science, Technology and Communication (FSTC) > Life Science Research Unit
Language :
English
Title :
Involuntary eyelid closure after STN-DBS: evidence for different pathophysiological entities.
Publication date :
2010
Journal title :
Journal of Neurology, Neurosurgery and Psychiatry
ISSN :
1468-330X
Publisher :
BMJ Publishing Group, United Kingdom
Volume :
81
Issue :
9
Pages :
1002-7
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBilu :
since 02 July 2014

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