Bilateral subthalamic nucleus stimulation improves balance control in Parkinson’s disease
Identifieur interne : 003185 ( Istex/Curation ); précédent : 003184; suivant : 003186Bilateral subthalamic nucleus stimulation improves balance control in Parkinson’s disease
Auteurs : S. Colnat-Coulbois [France] ; G C Gauchard [France] ; L. Maillard [France] ; G. Barroche [France] ; H. Vespignani [France] ; J. Auque [France] ; 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.
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DOI: 10.1136/jnnp.2004.047829
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Ph P. Perrin<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><wicri:noCountry code="subField">Performance</wicri:noCountry></affiliation>Le document en format XML
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Colnat-Coulbois</name><affiliation wicri:level="1"><mods:affiliation>Department of Neurosurgery, University Hospital of Nancy, Nancy 54000, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Neurosurgery, University Hospital of Nancy, Nancy 54000</wicri:regionArea></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 wicri:level="1"><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><country xml:lang="fr">France</country><wicri:regionArea>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</wicri:regionArea></affiliation></author><author><name sortKey="Maillard, L" sort="Maillard, L" uniqKey="Maillard L" first="L" last="Maillard">L. 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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></record>Pour manipuler ce document sous Unix (Dilib)
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