Parkinson rigidity : analysis and quantification of EMG for use in stereotactic neurosurgery in Parkinson's disease

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Parkinson's Disease (PD) is characterized by typical motor and non-motor symptoms one of which is rigidity. Today numerous therapy strategies exist. In the last decades, patients with symptoms refractory to medical therapy became candidates for neurosurgical interventions. Targeted areas for ablation or deep brain stimulation are thalamus, pallidum and subthalamic nucleus (STN).
Next to anatomical positioning, neurophysciological assessment is essential for optimal positioning of the electrodes in these procedures. Proper positioning of the electrodes is based on MR/CT based anatomical positioning in a stereotactic frame, micro-electrode recordings for neurophysiological positioning, low frequency stimulation to detect interference with internal capsule fibers and high frequency stimulation to detect interference with internal capsule fibers and high frequency stimulation for evaluation of clinical improvement of symptoms and of side effects.
The ongoing development of neurosurgical therapies and consequent demand for intra-operative neuromonitoring have stressed the need for quantification of rigidity, since in some procedures (targeted pallidum and STN) rigidity is one of the few parkinsonian symptoms which are present.

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