Top

Published in:

01-04-2011 | Movement Disorders - Short Communication

Micrographia induced by pallidal DBS for segmental dystonia: a subtle sign of hypokinesia?

Authors: Christian Blahak, Hans-Holger Capelle, Hansjoerg Baezner, Thomas M. Kinfe, Michael G. Hennerici, Joachim K. Krauss

Published in: Journal of Neural Transmission | Issue 4/2011

Abstract

Recently parkinsonism has been reported as a rare side effect of globus pallidus internus (GPi) deep brain stimulation (DBS) for dystonia. In the present systematic prospective study in 11 patients with segmental dystonia not affecting distal arm function, we could demonstrate significant changes in handwriting characterized by mild micrographia following GPi-DBS. We propose that this finding reflects GPi-DBS-induced disturbances of basal ganglia function in terms of a mild hypokinetic syndrome, as a result of outflow alterations in pallido-thalamo-cortical pathways.

Bejjani B, Damier P, Arnulf I, Bonnet AM, Vidailhet M, Dormont D, Pidoux B, Cornu P, Marsault C, Agid Y (1997) Pallidal stimulation for Parkinson’s disease: two targets? Neurology 49:1564–1569PubMed

Berman BD, Starr PA, Marks WJ Jr, Ostrem JL (2009) Induction of bradykinesia with pallidal deep brain stimulation in patients with cranial–cervical dystonia. Stereotact Funct Neurosurg 87:37–44PubMedCrossRef

Blahak C, Wöhrle JC, Capelle HH, Bäzner H, Grips E, Weigel R, Kekelia K, Krauss JK (2008) Health-related quality of life in segmental dystonia is improved by bilateral pallidal stimulation. J Neurol 255:178–182PubMedCrossRef

Capone F, Pilato F, Profice P, Pravatà E, Di Lazzaro V (2009) A case of stroke induced micrographia. J Neurol Neurosurg Psychiatry 80:1356PubMedCrossRef

Contreras-Vidal JL, Teulings HL, Stelmach GE (1995) Micrographia in Parkinson’s disease. Neuroreport 6:2089–2092PubMedCrossRef

Derkinderen P, Dupont S, Vidal JS, Chedru F, Vidailhet M (2002) Micrographia secondary to lenticular lesions. Mov Disord 17:835–837PubMedCrossRef

Diederich NJ, Kalteis K, Stamenkovic M, Pieri V, Alesch F (2005) Efficient internal pallidal stimulation in Gilles de la Tourette syndrome: a case report. Mov Disord 20:1496–1499PubMedCrossRef

Houeto JL, Yelnik J, Bardinet E et al (2007) Acute deep-brain stimulation of the internal and external globus pallidus in primary dystonia. Arch Neurol 64:1281–1286PubMedCrossRef

Ishihara T, Ozawa T, Otsuki M, Shimbo J, Tanaka K, Nishizawa M (2006) Atypical micrographia associated with corticostriatal white matter lesions in systemic lupus erythematosus. J Neurol Neurosurg Psychiatry 77:993–994PubMedCrossRef

Kim JS, Im JH, Kwon SU, Kang JH, Lee MC (1998) Micrographia after thalamo-mesencephalic infarction: evidence of striatal dopaminergic hypofunction. Neurology 51:625–627PubMed

Krack P, Pollak P, Limousin P, Hoffmann D, Benazzouz A, Le Bas JF, Koudsie A, Benabid AL (1998) Opposite motor effects of pallidal stimulation in Parkinson’s disease. Ann Neurol 43:80–92CrossRef

Krauss JK, Pohle T, Weber S, Ozdoba C, Burgunder JM (1999) Bilateral stimulation of globus pallidus internus for treatment of cervical dystonia. Lancet 354:837–838PubMed

Krauss JK, Yianni J, Loher TJ, Aziz TZ (2004) Deep brain stimulation for dystonia. J Clin Neurophysiol 21:18–30PubMedCrossRef

Kupsch A, Benecke R, Müller J et al (2006) Pallidal deep-brain stimulation in primary generalized or segmental dystonia. N Engl J Med 355:1978–1990PubMedCrossRef

Lewitt PA (1983) Micrographia as a focal sign in neurological disease. J Neurol Neurosurg Psychiatry 46:1152–1153PubMedCrossRef

McLennan JE, Nakano K, Tyler HR, Schwab RS (1972) Micrographia in Parkinson’s disease. J Neurol Sci 15:141–152PubMedCrossRef

Nakamura M, Hamamoto M, Uchida S, Nagayama H, Amemiya S, Okubo S, Tanaka K (2003) A case of micrographia after subcortical infarction: possible involvement of frontal lobe function. Eur J Neurol 10:593–596PubMedCrossRef

Noda S, Itoh H, Goda S (1994) Micrographia due to focal cerebral lesions as seen in the dysarthria clumsy hand syndrome. Neurology 44:150–151PubMed

Ostrem JL, Marks WJ Jr, Volz MM, Heath SL, Starr PA (2007) Pallidal deep brain stimulation in patients with cranial–cervical dystonia (Meige syndrome). Mov Disord 22:1885–1891PubMedCrossRef

Pick A (1903) Ueber eine eigentümliche Schreibstörung, Mikrographie, in Folge cerebraler Erkrankung. Prag Med Wschr 28:1–4

Pullicino P, Lichter D, Benedict R (1994) Micrographia with cognitive dysfunction: “minimal” sequelae of a putaminal infarct. Mov Disord 9:371–373PubMedCrossRef

Scolding NJ, Lees AJ (1994) Micrographia associated with a parietal lobe lesion in multiple sclerosis. J Neurol Neurosurg Psychiatry 57:739–741PubMedCrossRef

Tisch S, Zrinzo L, Limousin P, Bhatia KP, Quinn N, Ashkan K, Hariz M (2007) Effect of electrode contact location on clinical efficacy of pallidal deep brain stimulation in primary generalised dystonia. J Neurol Neurosurg Psychiatry 78:1314–1319PubMedCrossRef

Vidailhet M, Vercueil L, Houeto JL et al (2005) Bilateral deep-brain stimulation of the globus pallidus in primary generalized dystonia. N Engl J Med 352:459–467PubMedCrossRef

Wichmann T, DeLong MR (2003) Pathophysiology of Parkinson’s disease: the MPTP primate model of the human disorder. Ann N Y Acad Sci 991:199–213PubMedCrossRef

Zauber SE, Watson N, Comella CL, Bakay RA, Metman LV et al (2009) Stimulation-induced parkinsonism after posteroventral deep brain stimulation of the globus pallidus internus for craniocervical dystonia. J Neurosurg 110:229–233PubMedCrossRef

Title: Micrographia induced by pallidal DBS for segmental dystonia: a subtle sign of hypokinesia?
Authors: Christian Blahak
Hans-Holger Capelle
Hansjoerg Baezner
Thomas M. Kinfe
Michael G. Hennerici
Joachim K. Krauss
Publication date: 01-04-2011
Publisher: Springer Vienna
Published in: Journal of Neural Transmission / Issue 4/2011
Print ISSN: 0300-9564
Electronic ISSN: 1435-1463
DOI: https://doi.org/10.1007/s00702-010-0544-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Micrographia induced by pallidal DBS for segmental dystonia: a subtle sign of hypokinesia?

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 4/2011

Relation of risk factors and putative premotor markers for Parkinson’s disease

Epilepsy and other central nervous system diseases in atypical autism: a case control study

Editorial comments

Migraine is a neuronal disease

Transcranial magnetic stimulation in Alzheimer’s disease: a neurophysiological marker of cortical hyperexcitability

Asymptomatic carotid artery stenosis (ACAS)