Effects of Medication and Deep Brain Stimulation on the Finger-tapping Speed and Amplitude of Parkinsonian Bradykinesia

The purpose of this study is to investigate whether medication and deep brain stimulation (DBS) have differential effects on the speed and amplitude of bradykinesia in patients with Parkinson's disease (PD). Five PD patients with implanted DBS electrodes (age: 60.6 ± 7.4 yrs, H&Y stage: 3.1 ± 0.2) participated in this study. FT (finger tapping) movement was measured using a gyrosensor system in four treatment conditions: Med (Medication)off/DBS-off, Med-off/DBS-on, Med-on/DBS-off and Med-on/DBS-on. Quantitative measures representing average speed and amplitude of FT movement included root-mean-squared (RMS) angular velocity and RMS angle. One-way repeated measures ANOVA showed that RMS angular velocity of Med-on/DBS-on was significantly greater than those of Med-off/DBS-off and Med-off/DBS-on (p < 0.01) whereas RMS angle was not different among conditions (p = 0.06). Two way repeated measures ANOVA showed that only medication improved RMS angular velocity (p < 0.01), whereas both medication and DBS had no significant effect on RMS angle (p > 0.02). Effect size of RMS angular velocity was greater than that of RMS angle in both medication and DBS. This suggests that medication and DBS have differential effects on FT bradykinesia and velocity and amplitude impairments may be associated with different functional aspects in PD.