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Background: Recent animal experiments suggest an important role of descending input from basal ganglia to brainstem and via the reticulospinal tract (RST) to spinal cord in the genesis of motor symptoms in Parkinson disease (PD). In human s, a marker for RST activity is Ib mediated autogenic inhibition, which is reduc ed in PD patients. The authors investigated the effect of high frequency stimula tion of the subthalamic nucleus (STN HFS) on autogenic inhibition in PD. Method s: In 10 controls and 10 PD patients with chronically implanted STN electrodes, the soleus H reflex conditioned by gastrocnemius nerve stimulation (interstimul us interval 2 to 10 msec) was used to examine the effect of STN HFS on the acti vity f Ib spinal interneurons. Results: STN HFS was able to restore the abnorma lly reduced autogenic inhibition. The H reflex changes during STN HFS signific antly correlated with the clinical improvement of gait and posture. Conclusions: Observed changes in spinal autogenic inhibition may allow measurement of the co ntribution of subcortical routes to the STN HFS induced motor benefit in PD.
Background: Recent animal experiments suggest an important role of descending input from basal ganglia to brainstem and via the reticulospinal tract (RST) to spinal cord in the genesis of motor symptoms in Parkinson disease (PD). In human s, a marker for RST activity is Ib mediated autogenic inhibition, which is reduc ed in PD patients. The authors investigated the effect of high frequency stimula tion of the subthalamic nucleus (STN HFS) on autogenic inhibition in PD. Method s: In 10 controls and 10 PD patients with chronically implanted STN electrodes, the soleus H reflex conditioned by gastrocnemius nerve stimulation (interstimul us interval 2 to 10 msec) was used to examine the effect of STN HFS on the acti vity f Ib spinal interneurons. Results: STN HFS was able to restore the abnorma The H reflex changes during STN HFS significant antly correlated with the clinical improvement of gait and posture. Conclusions: Observed changes in spinal autogenic in hibition may allow measurement of the co ntribution of subcortical routes to the STN HFS induced motor benefit in PD.