Bilateral subthalamic nucleus stimulation improves balance control in Parkinson’s disease
Identifieur interne : 003225 ( Istex/Corpus ); précédent : 003224; suivant : 003226Bilateral subthalamic nucleus stimulation improves balance control in Parkinson’s disease
Auteurs : S. Colnat-Coulbois ; G C Gauchard ; L. Maillard ; G. Barroche ; H. Vespignani ; J. Auque ; Ph P. PerrinSource :
- Journal of Neurology, Neurosurgery & Psychiatry [ 0022-3050 ] ; 2005-06.
English descriptors
- KwdEn :
- ADT, adaptation test, AP, anterior–posterior, CoG, centre of gravity, CoP, centre of foot pressure, EC, eyes closed, EMG, electromyographic, EO, eyes open, ES, equilibrium score, FFT, fast Fourier transformation, L-Dopa, levodopa, LLR, long latency response, Lat, lateral sways, MLR, medium latency response, MRI, magnetic resonance imagery, PD, Parkinson’s disease, PPN, pedonculo-pontine nucleus, SLR, short latency response, SOT, sensory organisation test, SP, sway path, SS, strategy score, STN, subthalamic nucleus, df, degrees of freedom.
- Teeft :
- Adaptation test, Adaptation tests, Ankle strategy, Axial signs, Balance control, Balance disorders, Balance precision, Basal, Basal ganglia, Bejjani, Better quality, Bilateral subthalamic stimulation, Central electrode, Central information processing, Central information processing level, Central integration, Centre, Composite equilibrium score, Deep brain stimulation, Definitive electrode, Dimensional stereotactic, Dopaminergic, Dynamic postural control, Dynamic posturography, Dynamic test, Early disease, Electromyographic analysis, Equilibrium score, Equilibrium scores, First quartile, Foot pressure, Fourier transformation, Ganglion, High level, Latency, Lateral, Lateral sways, Levodopa, Long latency response, Medical research, Medication state, Medium latency response, Motor function, Motor performance, Motor signs, National institute, Neurol, Neurol neurosurg psychiatry, Neurosurg, Organisation, Path area, Pathway, Pedonculopontine nucleus, Peripheral information, Postoperative, Postoperative condition, Postoperative conditions, Postural, Postural adaptation, Postural adjustments, Postural control, Postural instability, Postural regulation, Postural responses, Postural tasks, Posturographic, Posturographic evaluations, Posturography platform, Preoperative, Preoperative condition, Proprioceptive, Proprioceptive regulation, Referenced, Regulation model, Sensorial, Sensorial conflict, Sensorial conflicts, Sensorimotor, Sensorimotor strategies, Sensorimotor strategy, Sensory conditions, Sensory organisation test, Short latency response, Significant differences, Somatosensory information, Spinal cord, Stimulation, Strategy score, Subthalamic, Subthalamic nucleus, Subthalamic stimulation, Support surface, Surgical procedure, Synergistic, Synergistic effect, Third quartile, Toennies gmbh, Total number, Typical recordings, University hospital, Vectorial analysis, Vestibular, Visual information, Weighted acquisitions.
Abstract
Background: Parkinson’s disease (PD), the most common basal ganglia degenerative disease, affects balance control, especially when patients change balance strategy during postural tasks. Bilateral chronic stimulation of the subthalamic nucleus (STN) is therapeutically useful in advanced PD, and reduces the motor signs of patients. Nevertheless, the effects of STN stimulation on postural control are still debatable. Aims: To assess the impact of bilateral STN stimulation on balance control in PD and to determine how basal ganglia related sensorimotor modifications act on neurosensorial organisation of balance and motor postural programming. Methods: Twelve subjects aged 45–70 years underwent unified Parkinson’s disease rating scale motor (part III) clinical tests, static and dynamic posturography, including sensory organisation and adaptation tests, shortly before and six months after bilateral implantation of electrodes into the STN. Results: The postoperative static test showed an improvement in postural control precision both in eyes open and eyes closed conditions. The dynamic test highlighted the decreased number of falls and the ability of the patients to develop more appropriate sensorimotor strategies when stimulated. The sensory organisation test showed an improvement of equilibrium score and, thus, a better resolution of sensorial conflicts. Conclusions: STN stimulation allowed a reduction in rigidity and therefore an improvement in the ability to use muscular proprioception as reliable information, resulting in vestibulo-proprioceptive conflict suppression. STN stimulation has a synergistic effect with levodopa for postural control. Accordingly, non-dopaminergic pathways could be involved in postural regulation and STN stimulation may influence the functioning of these pathways.
Url:
DOI: 10.1136/jnnp.2004.047829
Links to Exploration step
ISTEX:D312C0A8092B1829780F95B4651A372293DF6311Le document en format XML
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Colnat-Coulbois</name><affiliation><mods:affiliation>Department of Neurosurgery, University Hospital of Nancy, Nancy 54000, France</mods:affiliation></affiliation></author><author><name sortKey="Gauchard, G C" sort="Gauchard, G C" uniqKey="Gauchard G" first="G C" last="Gauchard">G C Gauchard</name><affiliation><mods:affiliation>National Institute for Health and Medical Research (INSERM), [EP]2R, Faculty of Medicine, Vandoeuvre-lès-Nancy 54500, and Balance Control and Motor Performance, UFR STAPS, Henri Poincaré-Nancy 1 University, Villers-lès-Nancy 54600, France</mods:affiliation></affiliation></author><author><name sortKey="Maillard, L" sort="Maillard, L" uniqKey="Maillard L" first="L" last="Maillard">L. Maillard</name><affiliation><mods:affiliation>Department of Neurology, University Hospital of Nancy</mods:affiliation></affiliation></author><author><name sortKey="Barroche, G" sort="Barroche, G" uniqKey="Barroche G" first="G" last="Barroche">G. Barroche</name><affiliation><mods:affiliation>Department of Neurology, University Hospital of Nancy</mods:affiliation></affiliation></author><author><name sortKey="Vespignani, H" sort="Vespignani, H" uniqKey="Vespignani H" first="H" last="Vespignani">H. Vespignani</name><affiliation><mods:affiliation>Department of Neurology, University Hospital of Nancy</mods:affiliation></affiliation></author><author><name sortKey="Auque, J" sort="Auque, J" uniqKey="Auque J" first="J" last="Auque">J. Auque</name><affiliation><mods:affiliation>Department of Neurosurgery, University Hospital of Nancy, Nancy 54000, France</mods:affiliation></affiliation></author><author><name sortKey="Perrin, Ph P" sort="Perrin, Ph P" uniqKey="Perrin P" first="Ph P" last="Perrin">Ph P. 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Colnat-Coulbois</name><affiliation><mods:affiliation>Department of Neurosurgery, University Hospital of Nancy, Nancy 54000, France</mods:affiliation></affiliation></author><author><name sortKey="Gauchard, G C" sort="Gauchard, G C" uniqKey="Gauchard G" first="G C" last="Gauchard">G C Gauchard</name><affiliation><mods:affiliation>National Institute for Health and Medical Research (INSERM), [EP]2R, Faculty of Medicine, Vandoeuvre-lès-Nancy 54500, and Balance Control and Motor Performance, UFR STAPS, Henri Poincaré-Nancy 1 University, Villers-lès-Nancy 54600, France</mods:affiliation></affiliation></author><author><name sortKey="Maillard, L" sort="Maillard, L" uniqKey="Maillard L" first="L" last="Maillard">L. Maillard</name><affiliation><mods:affiliation>Department of Neurology, University Hospital of Nancy</mods:affiliation></affiliation></author><author><name sortKey="Barroche, G" sort="Barroche, G" uniqKey="Barroche G" first="G" last="Barroche">G. Barroche</name><affiliation><mods:affiliation>Department of Neurology, University Hospital of Nancy</mods:affiliation></affiliation></author><author><name sortKey="Vespignani, H" sort="Vespignani, H" uniqKey="Vespignani H" first="H" last="Vespignani">H. Vespignani</name><affiliation><mods:affiliation>Department of Neurology, University Hospital of Nancy</mods:affiliation></affiliation></author><author><name sortKey="Auque, J" sort="Auque, J" uniqKey="Auque J" first="J" last="Auque">J. Auque</name><affiliation><mods:affiliation>Department of Neurosurgery, University Hospital of Nancy, Nancy 54000, France</mods:affiliation></affiliation></author><author><name sortKey="Perrin, Ph P" sort="Perrin, Ph P" uniqKey="Perrin P" first="Ph P" last="Perrin">Ph P. Perrin</name><affiliation><mods:affiliation>National Institute for Health and Medical Research (INSERM), [EP]2R, Faculty of Medicine, Vandoeuvre-lès-Nancy, and Balance Control and Motor Performance</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="ISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2005-06">2005-06</date><biblScope unit="volume">76</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="780">780</biblScope></imprint><idno type="ISSN">0022-3050</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0022-3050</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>ADT, adaptation test</term><term>AP, anterior–posterior</term><term>CoG, centre of gravity</term><term>CoP, centre of foot pressure</term><term>EC, eyes closed</term><term>EMG, electromyographic</term><term>EO, eyes open</term><term>ES, equilibrium score</term><term>FFT, fast Fourier transformation</term><term>L-Dopa, levodopa</term><term>LLR, long latency response</term><term>Lat, lateral sways</term><term>MLR, medium latency response</term><term>MRI, magnetic resonance imagery</term><term>PD, Parkinson’s disease</term><term>PPN, pedonculo-pontine nucleus</term><term>SLR, short latency response</term><term>SOT, sensory organisation test</term><term>SP, sway path</term><term>SS, strategy score</term><term>STN, subthalamic nucleus</term><term>df, degrees of freedom</term></keywords><keywords scheme="Teeft" xml:lang="en"><term>Adaptation test</term><term>Adaptation tests</term><term>Ankle strategy</term><term>Axial signs</term><term>Balance control</term><term>Balance disorders</term><term>Balance precision</term><term>Basal</term><term>Basal ganglia</term><term>Bejjani</term><term>Better quality</term><term>Bilateral subthalamic stimulation</term><term>Central electrode</term><term>Central information processing</term><term>Central information processing level</term><term>Central integration</term><term>Centre</term><term>Composite equilibrium score</term><term>Deep brain stimulation</term><term>Definitive electrode</term><term>Dimensional stereotactic</term><term>Dopaminergic</term><term>Dynamic postural control</term><term>Dynamic posturography</term><term>Dynamic test</term><term>Early disease</term><term>Electromyographic analysis</term><term>Equilibrium score</term><term>Equilibrium scores</term><term>First quartile</term><term>Foot pressure</term><term>Fourier transformation</term><term>Ganglion</term><term>High level</term><term>Latency</term><term>Lateral</term><term>Lateral sways</term><term>Levodopa</term><term>Long latency response</term><term>Medical research</term><term>Medication state</term><term>Medium latency response</term><term>Motor function</term><term>Motor performance</term><term>Motor signs</term><term>National institute</term><term>Neurol</term><term>Neurol neurosurg psychiatry</term><term>Neurosurg</term><term>Organisation</term><term>Path area</term><term>Pathway</term><term>Pedonculopontine nucleus</term><term>Peripheral information</term><term>Postoperative</term><term>Postoperative condition</term><term>Postoperative conditions</term><term>Postural</term><term>Postural adaptation</term><term>Postural adjustments</term><term>Postural control</term><term>Postural instability</term><term>Postural regulation</term><term>Postural responses</term><term>Postural tasks</term><term>Posturographic</term><term>Posturographic evaluations</term><term>Posturography platform</term><term>Preoperative</term><term>Preoperative condition</term><term>Proprioceptive</term><term>Proprioceptive regulation</term><term>Referenced</term><term>Regulation model</term><term>Sensorial</term><term>Sensorial conflict</term><term>Sensorial conflicts</term><term>Sensorimotor</term><term>Sensorimotor strategies</term><term>Sensorimotor strategy</term><term>Sensory conditions</term><term>Sensory organisation test</term><term>Short latency response</term><term>Significant differences</term><term>Somatosensory information</term><term>Spinal cord</term><term>Stimulation</term><term>Strategy score</term><term>Subthalamic</term><term>Subthalamic nucleus</term><term>Subthalamic stimulation</term><term>Support surface</term><term>Surgical procedure</term><term>Synergistic</term><term>Synergistic effect</term><term>Third quartile</term><term>Toennies gmbh</term><term>Total number</term><term>Typical recordings</term><term>University hospital</term><term>Vectorial analysis</term><term>Vestibular</term><term>Visual information</term><term>Weighted acquisitions</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background: Parkinson’s disease (PD), the most common basal ganglia degenerative disease, affects balance control, especially when patients change balance strategy during postural tasks. Bilateral chronic stimulation of the subthalamic nucleus (STN) is therapeutically useful in advanced PD, and reduces the motor signs of patients. Nevertheless, the effects of STN stimulation on postural control are still debatable. Aims: To assess the impact of bilateral STN stimulation on balance control in PD and to determine how basal ganglia related sensorimotor modifications act on neurosensorial organisation of balance and motor postural programming. Methods: Twelve subjects aged 45–70 years underwent unified Parkinson’s disease rating scale motor (part III) clinical tests, static and dynamic posturography, including sensory organisation and adaptation tests, shortly before and six months after bilateral implantation of electrodes into the STN. Results: The postoperative static test showed an improvement in postural control precision both in eyes open and eyes closed conditions. The dynamic test highlighted the decreased number of falls and the ability of the patients to develop more appropriate sensorimotor strategies when stimulated. The sensory organisation test showed an improvement of equilibrium score and, thus, a better resolution of sensorial conflicts. Conclusions: STN stimulation allowed a reduction in rigidity and therefore an improvement in the ability to use muscular proprioception as reliable information, resulting in vestibulo-proprioceptive conflict suppression. STN stimulation has a synergistic effect with levodopa for postural control. Accordingly, non-dopaminergic pathways could be involved in postural regulation and STN stimulation may influence the functioning of these pathways.</div></front></TEI><istex><corpusName>bmj</corpusName><keywords><teeft><json:string>postural</json:string><json:string>postural control</json:string><json:string>posturographic</json:string><json:string>neurol</json:string><json:string>sensorimotor</json:string><json:string>vestibular</json:string><json:string>basal</json:string><json:string>balance control</json:string><json:string>subthalamic</json:string><json:string>ganglion</json:string><json:string>postoperative</json:string><json:string>preoperative</json:string><json:string>neurosurg</json:string><json:string>organisation</json:string><json:string>referenced</json:string><json:string>sensorial</json:string><json:string>pathway</json:string><json:string>neurol neurosurg 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Colnat-Coulbois</name><affiliations><json:string>Department of Neurosurgery, University Hospital of Nancy, Nancy 54000, France</json:string></affiliations></json:item><json:item><name>G C Gauchard</name><affiliations><json:string>National Institute for Health and Medical Research (INSERM), [EP]2R, Faculty of Medicine, Vandoeuvre-lès-Nancy 54500, and Balance Control and Motor Performance, UFR STAPS, Henri Poincaré-Nancy 1 University, Villers-lès-Nancy 54600, France</json:string></affiliations></json:item><json:item><name>L Maillard</name><affiliations><json:string>Department of Neurology, University Hospital of Nancy</json:string></affiliations></json:item><json:item><name>G Barroche</name><affiliations><json:string>Department of Neurology, University Hospital of Nancy</json:string></affiliations></json:item><json:item><name>H Vespignani</name><affiliations><json:string>Department of Neurology, University Hospital of Nancy</json:string></affiliations></json:item><json:item><name>J Auque</name><affiliations><json:string>Department of Neurosurgery, University Hospital of Nancy, Nancy 54000, France</json:string></affiliations></json:item><json:item><name>Ph P Perrin</name><affiliations><json:string>National Institute for Health and Medical Research (INSERM), [EP]2R, Faculty of Medicine, Vandoeuvre-lès-Nancy, and Balance Control and Motor Performance</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>ADT, adaptation test</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>AP, anterior–posterior</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>CoP, centre of foot pressure</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>CoG, centre of gravity</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>df, degrees of freedom</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>EC, eyes closed</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>EMG, electromyographic</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>EO, eyes open</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>ES, equilibrium score</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>FFT, fast Fourier transformation</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Lat, lateral sways</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>L-Dopa, levodopa</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>LLR, long latency response</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>MLR, medium latency response</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>MRI, magnetic resonance imagery</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>PD, Parkinson’s disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>PPN, pedonculo-pontine nucleus</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>SLR, short latency response</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>SOT, sensory organisation test</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>SP, sway path</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>SS, strategy score</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>STN, subthalamic nucleus</value></json:item></subject><arkIstex>ark:/67375/NVC-V2JT55DL-5</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>research-article</json:string></originalGenre><abstract>Background: Parkinson’s disease (PD), the most common basal ganglia degenerative disease, affects balance control, especially when patients change balance strategy during postural tasks. Bilateral chronic stimulation of the subthalamic nucleus (STN) is therapeutically useful in advanced PD, and reduces the motor signs of patients. Nevertheless, the effects of STN stimulation on postural control are still debatable. Aims: To assess the impact of bilateral STN stimulation on balance control in PD and to determine how basal ganglia related sensorimotor modifications act on neurosensorial organisation of balance and motor postural programming. Methods: Twelve subjects aged 45–70 years underwent unified Parkinson’s disease rating scale motor (part III) clinical tests, static and dynamic posturography, including sensory organisation and adaptation tests, shortly before and six months after bilateral implantation of electrodes into the STN. Results: The postoperative static test showed an improvement in postural control precision both in eyes open and eyes closed conditions. The dynamic test highlighted the decreased number of falls and the ability of the patients to develop more appropriate sensorimotor strategies when stimulated. The sensory organisation test showed an improvement of equilibrium score and, thus, a better resolution of sensorial conflicts. Conclusions: STN stimulation allowed a reduction in rigidity and therefore an improvement in the ability to use muscular proprioception as reliable information, resulting in vestibulo-proprioceptive conflict suppression. STN stimulation has a synergistic effect with levodopa for postural control. Accordingly, non-dopaminergic pathways could be involved in postural regulation and STN stimulation may influence the functioning of these pathways.</abstract><qualityIndicators><score>9.964</score><pdfWordCount>5825</pdfWordCount><pdfCharCount>39468</pdfCharCount><pdfVersion>1.3</pdfVersion><pdfPageCount>8</pdfPageCount><pdfPageSize>612 x 792 pts (letter)</pdfPageSize><refBibsNative>true</refBibsNative><abstractWordCount>247</abstractWordCount><abstractCharCount>1819</abstractCharCount><keywordCount>22</keywordCount></qualityIndicators><title>Bilateral subthalamic nucleus stimulation improves balance control in Parkinson’s disease</title><pmid><json:string>15897498</json:string></pmid><genre><json:string>research-article</json:string></genre><host><title>Journal of Neurology, Neurosurgery & Psychiatry</title><language><json:string>unknown</json:string></language><issn><json:string>0022-3050</json:string></issn><eissn><json:string>1468-330X</json:string></eissn><volume>76</volume><issue>6</issue><pages><first>780</first></pages><genre><json:string>journal</json:string></genre></host><namedEntities><unitex><date><json:string>2005-05-16</json:string></date><geogName></geogName><orgName><json:string>National Institute for Health and Medical Research</json:string><json:string>Ministry of Health</json:string><json:string>Department of Neurosurgery, University Hospital of Nancy, Nancy</json:string><json:string>Department of Neurology, University Hospital of Nancy P P Perrin, National Institute for Health and Medical Research</json:string><json:string>INSERM</json:string></orgName><orgName_funder></orgName_funder><orgName_provider></orgName_provider><persName><json:string>Henri Poincare-Nancy</json:string><json:string>Rocchi</json:string></persName><placeName><json:string>Minneapolis</json:string><json:string>Germany</json:string><json:string>Berkeley</json:string><json:string>France</json:string></placeName><ref_url></ref_url><ref_bibl><json:string>Bejjani et al.</json:string><json:string>Maurer et al</json:string><json:string>Bronstein et al</json:string><json:string>Welter et al</json:string><json:string>Bloem et al</json:string><json:string>Perrin et al</json:string><json:string>Bejjani et al</json:string></ref_bibl><bibl></bibl></unitex></namedEntities><ark><json:string>ark:/67375/NVC-V2JT55DL-5</json:string></ark><categories><wos><json:string>1 - social science</json:string><json:string>2 - psychiatry</json:string><json:string>1 - science</json:string><json:string>2 - surgery</json:string><json:string>2 - clinical neurology</json:string></wos><scienceMetrix><json:string>1 - health sciences</json:string><json:string>2 - clinical medicine</json:string><json:string>3 - neurology & neurosurgery</json:string></scienceMetrix><scopus><json:string>1 - Health Sciences</json:string><json:string>2 - Medicine</json:string><json:string>3 - Psychiatry and Mental health</json:string><json:string>1 - Health Sciences</json:string><json:string>2 - Medicine</json:string><json:string>3 - Clinical Neurology</json:string><json:string>1 - Health Sciences</json:string><json:string>2 - Medicine</json:string><json:string>3 - Surgery</json:string></scopus><inist><json:string>1 - sciences appliquees, technologies et medecines</json:string><json:string>2 - sciences biologiques et medicales</json:string><json:string>3 - sciences medicales</json:string></inist></categories><publicationDate>2005</publicationDate><copyrightDate>2005</copyrightDate><doi><json:string>10.1136/jnnp.2004.047829</json:string></doi><id>D312C0A8092B1829780F95B4651A372293DF6311</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/ark:/67375/NVC-V2JT55DL-5/fulltext.pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/ark:/67375/NVC-V2JT55DL-5/bundle.zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/ark:/67375/NVC-V2JT55DL-5/fulltext.tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Bilateral subthalamic nucleus stimulation improves balance control in Parkinson’s disease</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher scheme="https://publisher-list.data.istex.fr">BMJ Publishing Group Ltd</publisher><availability><licence><p>Copyright 2005 Journal of Neurology Neurosurgery and Psychiatry</p></licence><p scheme="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-7M42M2QJ-2">bmj</p></availability><date>2005-05-16</date></publicationStmt><notesStmt><note type="research-article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</note><note type="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note><note>Correspondence to:
Professor P P Perrin
Equilibration et Performance Motrice, UFR STAPS, Université Henri Poincaré-Nancy 1, 30, rue du Jardin Botanique, 54600 Villers-lès-Nancy, France; Philippe.Perrin@staps.uhp-nancy.fr</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Bilateral subthalamic nucleus stimulation improves balance control in Parkinson’s disease</title><author xml:id="author-0000"><persName><forename type="first">S</forename><surname>Colnat-Coulbois</surname></persName><affiliation>Department of Neurosurgery, University Hospital of Nancy, Nancy 54000, France</affiliation></author><author xml:id="author-0001"><persName><forename type="first">G C</forename><surname>Gauchard</surname></persName><affiliation>National Institute for Health and Medical Research (INSERM), [EP]2R, Faculty of Medicine, Vandoeuvre-lès-Nancy 54500, and Balance Control and Motor Performance, UFR STAPS, Henri Poincaré-Nancy 1 University, Villers-lès-Nancy 54600, France</affiliation></author><author xml:id="author-0002"><persName><forename type="first">L</forename><surname>Maillard</surname></persName><affiliation>Department of Neurology, University Hospital of Nancy</affiliation></author><author xml:id="author-0003"><persName><forename type="first">G</forename><surname>Barroche</surname></persName><affiliation>Department of Neurology, University Hospital of Nancy</affiliation></author><author xml:id="author-0004"><persName><forename type="first">H</forename><surname>Vespignani</surname></persName><affiliation>Department of Neurology, University Hospital of Nancy</affiliation></author><author xml:id="author-0005"><persName><forename type="first">J</forename><surname>Auque</surname></persName><affiliation>Department of Neurosurgery, University Hospital of Nancy, Nancy 54000, France</affiliation></author><author xml:id="author-0006"><persName><forename type="first">Ph P</forename><surname>Perrin</surname></persName><affiliation>National Institute for Health and Medical Research (INSERM), [EP]2R, Faculty of Medicine, Vandoeuvre-lès-Nancy, and Balance Control and Motor Performance</affiliation></author><idno type="istex">D312C0A8092B1829780F95B4651A372293DF6311</idno><idno type="ark">ark:/67375/NVC-V2JT55DL-5</idno><idno type="DOI">10.1136/jnnp.2004.047829</idno><idno type="href">jnnp-76-780.pdf</idno><idno type="PMID">15897498</idno><idno type="local">0760780</idno></analytic><monogr><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="pISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><idno type="PublisherID-hwp">jnnp</idno><idno type="PublisherID-nlm-ta">J Neurol Neurosurg Psychiatry</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2005-06"></date><biblScope unit="volume">76</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="780">780</biblScope></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2005-05-16</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Background: Parkinson’s disease (PD), the most common basal ganglia degenerative disease, affects balance control, especially when patients change balance strategy during postural tasks. Bilateral chronic stimulation of the subthalamic nucleus (STN) is therapeutically useful in advanced PD, and reduces the motor signs of patients. Nevertheless, the effects of STN stimulation on postural control are still debatable. Aims: To assess the impact of bilateral STN stimulation on balance control in PD and to determine how basal ganglia related sensorimotor modifications act on neurosensorial organisation of balance and motor postural programming. Methods: Twelve subjects aged 45–70 years underwent unified Parkinson’s disease rating scale motor (part III) clinical tests, static and dynamic posturography, including sensory organisation and adaptation tests, shortly before and six months after bilateral implantation of electrodes into the STN. Results: The postoperative static test showed an improvement in postural control precision both in eyes open and eyes closed conditions. The dynamic test highlighted the decreased number of falls and the ability of the patients to develop more appropriate sensorimotor strategies when stimulated. The sensory organisation test showed an improvement of equilibrium score and, thus, a better resolution of sensorial conflicts. Conclusions: STN stimulation allowed a reduction in rigidity and therefore an improvement in the ability to use muscular proprioception as reliable information, resulting in vestibulo-proprioceptive conflict suppression. STN stimulation has a synergistic effect with levodopa for postural control. Accordingly, non-dopaminergic pathways could be involved in postural regulation and STN stimulation may influence the functioning of these pathways.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>ABR</head><item><term>ADT, adaptation test</term></item><item><term>AP, anterior–posterior</term></item><item><term>CoP, centre of foot pressure</term></item><item><term>CoG, centre of gravity</term></item><item><term>df, degrees of freedom</term></item><item><term>EC, eyes closed</term></item><item><term>EMG, electromyographic</term></item><item><term>EO, eyes open</term></item><item><term>ES, equilibrium score</term></item><item><term>FFT, fast Fourier transformation</term></item><item><term>Lat, lateral sways</term></item><item><term>L-Dopa, levodopa</term></item><item><term>LLR, long latency response</term></item><item><term>MLR, medium latency response</term></item><item><term>MRI, magnetic resonance imagery</term></item><item><term>PD, Parkinson’s disease</term></item><item><term>PPN, pedonculo-pontine nucleus</term></item><item><term>SLR, short latency response</term></item><item><term>SOT, sensory organisation test</term></item><item><term>SP, sway path</term></item><item><term>SS, strategy score</term></item><item><term>STN, subthalamic nucleus</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2005-05-16">Created</change><change when="2005-06">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/ark:/67375/NVC-V2JT55DL-5/fulltext.txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus bmj" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="no"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Archiving and Interchange DTD v2.3 20070202//EN" URI="archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article xml:lang="en" article-type="research-article"><front><journal-meta><journal-id journal-id-type="hwp">jnnp</journal-id><journal-id journal-id-type="nlm-ta">J Neurol Neurosurg Psychiatry</journal-id><journal-title>Journal of Neurology, Neurosurgery & Psychiatry</journal-title><abbrev-journal-title abbrev-type="publisher">J Neurol Neurosurg Psychiatry</abbrev-journal-title><issn pub-type="ppub">0022-3050</issn><issn pub-type="epub">1468-330X</issn><publisher><publisher-name>BMJ Publishing Group Ltd</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="other">0760780</article-id><article-id pub-id-type="doi">10.1136/jnnp.2004.047829</article-id><article-id pub-id-type="other">jnnp;76/6/780</article-id><article-id pub-id-type="pmid">15897498</article-id><article-id pub-id-type="other">780</article-id><article-id pub-id-type="other">jnnp.2004.047829</article-id><article-categories><subj-group subj-group-type="heading"><subject content-type="original">Papers</subject></subj-group></article-categories><title-group><article-title>Bilateral subthalamic nucleus stimulation improves balance control in Parkinson’s disease</article-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Colnat-Coulbois</surname><given-names>S</given-names></name><xref rid="AFF1">1</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Gauchard</surname><given-names>G C</given-names></name><xref rid="AFF2">2</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Maillard</surname><given-names>L</given-names></name><xref rid="AFF3">3</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Barroche</surname><given-names>G</given-names></name><xref rid="AFF3">3</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Vespignani</surname><given-names>H</given-names></name><xref rid="AFF3">3</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Auque</surname><given-names>J</given-names></name><xref rid="AFF1">1</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Perrin</surname><given-names>Ph P</given-names></name><xref rid="AFF4">4</xref></contrib><aff id="AFF1"><label>1</label>Department of Neurosurgery, University Hospital of Nancy, Nancy 54000, France</aff><aff id="AFF2"><label>2</label>National Institute for Health and Medical Research (INSERM), [EP]<sup>2</sup>R, Faculty of Medicine, Vandoeuvre-lès-Nancy 54500, and Balance Control and Motor Performance, UFR STAPS, Henri Poincaré-Nancy 1 University, Villers-lès-Nancy 54600, France</aff><aff id="AFF3"><label>3</label>Department of Neurology, University Hospital of Nancy</aff><aff id="AFF4"><label>4</label>National Institute for Health and Medical Research (INSERM), [EP]<sup>2</sup>R, Faculty of Medicine, Vandoeuvre-lès-Nancy, and Balance Control and Motor Performance</aff></contrib-group><author-notes><corresp>Correspondence to:
Professor P P Perrin
Equilibration et Performance Motrice, UFR STAPS, Université Henri Poincaré-Nancy 1, 30, rue du Jardin Botanique, 54600 Villers-lès-Nancy, France; <ext-link xlink:href="Philippe.Perrinstaps.uhp-nancy.fr" ext-link-type="email" xlink:type="simple">Philippe.Perrin@staps.uhp-nancy.fr</ext-link></corresp></author-notes><pub-date pub-type="ppub"><month>6</month><year>2005</year></pub-date><pub-date pub-type="epub"><day>16</day><month>5</month><year>2005</year></pub-date><volume>76</volume><volume-id pub-id-type="other">76</volume-id><volume-id pub-id-type="other">76</volume-id><issue>6</issue><issue-id pub-id-type="other">jnnp;76/6</issue-id><issue-id pub-id-type="other">6</issue-id><issue-id pub-id-type="other">76/6</issue-id><fpage>780</fpage><history><date date-type="accepted"><day>13</day><month>09</month><year>2004</year></date><date date-type="received"><day>17</day><month>06</month><year>2004</year></date><date date-type="rev-recd"><day>02</day><month>09</month><year>2004</year></date></history><permissions><copyright-statement>Copyright 2005 Journal of Neurology Neurosurgery and Psychiatry</copyright-statement><copyright-year>2005</copyright-year></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="jnnp-76-780.pdf"></self-uri><abstract xml:lang="en"><p><bold>Background:</bold> Parkinson’s disease (PD), the most common basal ganglia degenerative disease, affects balance control, especially when patients change balance strategy during postural tasks. Bilateral chronic stimulation of the subthalamic nucleus (STN) is therapeutically useful in advanced PD, and reduces the motor signs of patients. Nevertheless, the effects of STN stimulation on postural control are still debatable.</p><p><bold>Aims:</bold> To assess the impact of bilateral STN stimulation on balance control in PD and to determine how basal ganglia related sensorimotor modifications act on neurosensorial organisation of balance and motor postural programming.</p><p><bold>Methods:</bold> Twelve subjects aged 45–70 years underwent unified Parkinson’s disease rating scale motor (part III) clinical tests, static and dynamic posturography, including sensory organisation and adaptation tests, shortly before and six months after bilateral implantation of electrodes into the STN.</p><p><bold>Results:</bold> The postoperative static test showed an improvement in postural control precision both in eyes open and eyes closed conditions. The dynamic test highlighted the decreased number of falls and the ability of the patients to develop more appropriate sensorimotor strategies when stimulated. The sensory organisation test showed an improvement of equilibrium score and, thus, a better resolution of sensorial conflicts.</p><p><bold>Conclusions:</bold> STN stimulation allowed a reduction in rigidity and therefore an improvement in the ability to use muscular proprioception as reliable information, resulting in vestibulo-proprioceptive conflict suppression. STN stimulation has a synergistic effect with levodopa for postural control. Accordingly, non-dopaminergic pathways could be involved in postural regulation and STN stimulation may influence the functioning of these pathways.</p></abstract><kwd-group kwd-group-type="ABR" xml:lang="en"><kwd>ADT, adaptation test</kwd><kwd>AP, anterior–posterior</kwd><kwd>CoP, centre of foot pressure</kwd><kwd>CoG, centre of gravity</kwd><kwd>df, degrees of freedom</kwd><kwd>EC, eyes closed</kwd><kwd>EMG, electromyographic</kwd><kwd>EO, eyes open</kwd><kwd>ES, equilibrium score</kwd><kwd>FFT, fast Fourier transformation</kwd><kwd>Lat, lateral sways</kwd><kwd>L-Dopa, levodopa</kwd><kwd>LLR, long latency response</kwd><kwd>MLR, medium latency response</kwd><kwd>MRI, magnetic resonance imagery</kwd><kwd>PD, Parkinson’s disease</kwd><kwd>PPN, pedonculo-pontine nucleus</kwd><kwd>SLR, short latency response</kwd><kwd>SOT, sensory organisation test</kwd><kwd>SP, sway path</kwd><kwd>SS, strategy score</kwd><kwd>STN, subthalamic nucleus</kwd></kwd-group></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Bilateral subthalamic nucleus stimulation improves balance control in Parkinson’s disease</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Bilateral subthalamic nucleus stimulation improves balance control in Parkinson’s disease</title></titleInfo><name type="personal"><namePart type="given">S</namePart><namePart type="family">Colnat-Coulbois</namePart><affiliation>Department of Neurosurgery, University Hospital of Nancy, Nancy 54000, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">G C</namePart><namePart type="family">Gauchard</namePart><affiliation>National Institute for Health and Medical Research (INSERM), [EP]2R, Faculty of Medicine, Vandoeuvre-lès-Nancy 54500, and Balance Control and Motor Performance, UFR STAPS, Henri Poincaré-Nancy 1 University, Villers-lès-Nancy 54600, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">L</namePart><namePart type="family">Maillard</namePart><affiliation>Department of Neurology, University Hospital of Nancy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">G</namePart><namePart type="family">Barroche</namePart><affiliation>Department of Neurology, University Hospital of Nancy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">H</namePart><namePart type="family">Vespignani</namePart><affiliation>Department of Neurology, University Hospital of Nancy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">J</namePart><namePart type="family">Auque</namePart><affiliation>Department of Neurosurgery, University Hospital of Nancy, Nancy 54000, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ph P</namePart><namePart type="family">Perrin</namePart><affiliation>National Institute for Health and Medical Research (INSERM), [EP]2R, Faculty of Medicine, Vandoeuvre-lès-Nancy, and Balance Control and Motor Performance</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</genre><originInfo><publisher>BMJ Publishing Group Ltd</publisher><dateIssued encoding="w3cdtf">2005-06</dateIssued><dateCreated encoding="w3cdtf">2005-05-16</dateCreated><copyrightDate encoding="w3cdtf">2005</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><abstract lang="en">Background: Parkinson’s disease (PD), the most common basal ganglia degenerative disease, affects balance control, especially when patients change balance strategy during postural tasks. Bilateral chronic stimulation of the subthalamic nucleus (STN) is therapeutically useful in advanced PD, and reduces the motor signs of patients. Nevertheless, the effects of STN stimulation on postural control are still debatable. Aims: To assess the impact of bilateral STN stimulation on balance control in PD and to determine how basal ganglia related sensorimotor modifications act on neurosensorial organisation of balance and motor postural programming. Methods: Twelve subjects aged 45–70 years underwent unified Parkinson’s disease rating scale motor (part III) clinical tests, static and dynamic posturography, including sensory organisation and adaptation tests, shortly before and six months after bilateral implantation of electrodes into the STN. Results: The postoperative static test showed an improvement in postural control precision both in eyes open and eyes closed conditions. The dynamic test highlighted the decreased number of falls and the ability of the patients to develop more appropriate sensorimotor strategies when stimulated. The sensory organisation test showed an improvement of equilibrium score and, thus, a better resolution of sensorial conflicts. Conclusions: STN stimulation allowed a reduction in rigidity and therefore an improvement in the ability to use muscular proprioception as reliable information, resulting in vestibulo-proprioceptive conflict suppression. STN stimulation has a synergistic effect with levodopa for postural control. Accordingly, non-dopaminergic pathways could be involved in postural regulation and STN stimulation may influence the functioning of these pathways.</abstract><note type="author-notes">Correspondence to:
Professor P P Perrin
Equilibration et Performance Motrice, UFR STAPS, Université Henri Poincaré-Nancy 1, 30, rue du Jardin Botanique, 54600 Villers-lès-Nancy, France; Philippe.Perrin@staps.uhp-nancy.fr</note><subject lang="en"><genre>ABR</genre><topic>ADT, adaptation test</topic><topic>AP, anterior–posterior</topic><topic>CoP, centre of foot pressure</topic><topic>CoG, centre of gravity</topic><topic>df, degrees of freedom</topic><topic>EC, eyes closed</topic><topic>EMG, electromyographic</topic><topic>EO, eyes open</topic><topic>ES, equilibrium score</topic><topic>FFT, fast Fourier transformation</topic><topic>Lat, lateral sways</topic><topic>L-Dopa, levodopa</topic><topic>LLR, long latency response</topic><topic>MLR, medium latency response</topic><topic>MRI, magnetic resonance imagery</topic><topic>PD, Parkinson’s disease</topic><topic>PPN, pedonculo-pontine nucleus</topic><topic>SLR, short latency response</topic><topic>SOT, sensory organisation test</topic><topic>SP, sway path</topic><topic>SS, strategy score</topic><topic>STN, subthalamic nucleus</topic></subject><relatedItem type="host"><titleInfo><title>Journal of Neurology, Neurosurgery & Psychiatry</title></titleInfo><titleInfo type="abbreviated"><title>J Neurol Neurosurg Psychiatry</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><identifier type="ISSN">0022-3050</identifier><identifier type="eISSN">1468-330X</identifier><identifier type="PublisherID-hwp">jnnp</identifier><identifier type="PublisherID-nlm-ta">J Neurol Neurosurg Psychiatry</identifier><part><date>2005</date><detail type="volume"><caption>vol.</caption><number>76</number></detail><detail type="issue"><caption>no.</caption><number>6</number></detail><extent unit="pages"><start>780</start></extent></part></relatedItem><identifier type="istex">D312C0A8092B1829780F95B4651A372293DF6311</identifier><identifier type="ark">ark:/67375/NVC-V2JT55DL-5</identifier><identifier type="DOI">10.1136/jnnp.2004.047829</identifier><identifier type="href">jnnp-76-780.pdf</identifier><identifier type="PMID">15897498</identifier><identifier type="local">0760780</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright 2005 Journal of Neurology Neurosurgery and Psychiatry</accessCondition><recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-7M42M2QJ-2">bmj</recordContentSource><recordOrigin>Copyright 2005 Journal of Neurology Neurosurgery and Psychiatry</recordOrigin></recordInfo></mods><json:item><extension>json</extension><original>false</original><mimetype>application/json</mimetype><uri>https://api.istex.fr/ark:/67375/NVC-V2JT55DL-5/record.json</uri></json:item></metadata><annexes><json:item><extension>jpeg</extension><original>true</original><mimetype>image/jpeg</mimetype><uri>https://api.istex.fr/ark:/67375/NVC-V2JT55DL-5/annexes.jpeg</uri></json:item></annexes><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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