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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Medication and subthalamic nucleus deep brain stimulation similarly improve balance and complex gait in Parkinson disease</title>
<author><name sortKey="Mcneely, Marie E" sort="Mcneely, Marie E" uniqKey="Mcneely M" first="Marie E." last="Mcneely">Marie E. Mcneely</name>
<affiliation><nlm:aff id="A1">Program in Physical Therapy, Washington University in St. Louis, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A2">Program in Neuroscience, Division of Biology and Biomedical Sciences, Washington University in St. Louis, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Earhart, Gammon M" sort="Earhart, Gammon M" uniqKey="Earhart G" first="Gammon M." last="Earhart">Gammon M. Earhart</name>
<affiliation><nlm:aff id="A1">Program in Physical Therapy, Washington University in St. Louis, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A3">Department of Anatomy and Neurobiology, Washington University in St. Louis, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A4">Department of Neurology, Washington University in St. Louis, USA</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">22885253</idno>
<idno type="pmc">3508177</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3508177</idno>
<idno type="RBID">PMC:3508177</idno>
<idno type="doi">10.1016/j.parkreldis.2012.07.013</idno>
<date when="2012">2012</date>
<idno type="wicri:Area/Pmc/Corpus">000268</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000268</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Medication and subthalamic nucleus deep brain stimulation similarly improve balance and complex gait in Parkinson disease</title>
<author><name sortKey="Mcneely, Marie E" sort="Mcneely, Marie E" uniqKey="Mcneely M" first="Marie E." last="Mcneely">Marie E. Mcneely</name>
<affiliation><nlm:aff id="A1">Program in Physical Therapy, Washington University in St. Louis, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A2">Program in Neuroscience, Division of Biology and Biomedical Sciences, Washington University in St. Louis, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Earhart, Gammon M" sort="Earhart, Gammon M" uniqKey="Earhart G" first="Gammon M." last="Earhart">Gammon M. Earhart</name>
<affiliation><nlm:aff id="A1">Program in Physical Therapy, Washington University in St. Louis, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A3">Department of Anatomy and Neurobiology, Washington University in St. Louis, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A4">Department of Neurology, Washington University in St. Louis, USA</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">Parkinsonism & related disorders</title>
<idno type="ISSN">1353-8020</idno>
<idno type="eISSN">1873-5126</idno>
<imprint><date when="2012">2012</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P2">Dopaminergic medications and subthalamic nucleus deep brain stimulation (STN-DBS) alleviate motor symptoms in Parkinson disease, but balance and gait are more variably affected. Balance reports are particularly inconsistent. Further, despite their prevalence in daily life, complex gait situations including backward and dual task gait are rarely studied. We aimed to assess how medications, STN-DBS, and both therapies combined affect balance and complex gait.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P3">Twelve people with Parkinson disease were evaluated OFF medication with STN-DBS OFF and ON as well as ON medication with STN-DBS OFF and ON. Motor impairment was measured with the Movement Disorder Society Unified Parkinson Disease Rating Scale motor section (MDS-UPDRS-III). The Mini-Balance Evaluations Systems Test, timed-up-and-go, and dual task timed-up-and-go measured balance and mobility. Preferred-pace forward, fast as possible, backward, dual task forward, and dual task backward gait were also analyzed.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P4">Medication improved MDS-UPDRS-III scores, dual task timed-up-and-go, and stride length across all gait tasks. STN-DBS improved MDS-UPDRS-III scores, balance scores, dual task timed-up-and-go, and stride length and velocity across all gait tasks. Medication and STN-DBS combined did not provide additional benefits over either therapy alone.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P5">Overall, dopaminergic medications and STN-DBS provided similar improvements in balance and gait tasks, although the effects of STN-DBS were stronger, potentially due to reductions in medication doses after surgery. Lack of synergistic effect of treatments may suggest both therapies improve balance and gait by influencing similar neural pathways.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">9513583</journal-id>
<journal-id journal-id-type="pubmed-jr-id">21522</journal-id>
<journal-id journal-id-type="nlm-ta">Parkinsonism Relat Disord</journal-id>
<journal-id journal-id-type="iso-abbrev">Parkinsonism Relat. Disord.</journal-id>
<journal-title-group><journal-title>Parkinsonism & related disorders</journal-title>
</journal-title-group>
<issn pub-type="ppub">1353-8020</issn>
<issn pub-type="epub">1873-5126</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">22885253</article-id>
<article-id pub-id-type="pmc">3508177</article-id>
<article-id pub-id-type="doi">10.1016/j.parkreldis.2012.07.013</article-id>
<article-id pub-id-type="manuscript">NIHMS398855</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Medication and subthalamic nucleus deep brain stimulation similarly improve balance and complex gait in Parkinson disease</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>McNeely</surname>
<given-names>Marie E.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Earhart</surname>
<given-names>Gammon M.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A3">3</xref>
<xref ref-type="aff" rid="A4">4</xref>
<xref rid="FN1" ref-type="author-notes">*</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
Program in Physical Therapy, Washington University in St. Louis, USA</aff>
<aff id="A2"><label>2</label>
Program in Neuroscience, Division of Biology and Biomedical Sciences, Washington University in St. Louis, USA</aff>
<aff id="A3"><label>3</label>
Department of Anatomy and Neurobiology, Washington University in St. Louis, USA</aff>
<aff id="A4"><label>4</label>
Department of Neurology, Washington University in St. Louis, USA</aff>
<author-notes><corresp id="FN1"><label>*</label>
Correspondence to: Gammon M. Earhart, Program in Physical Therapy, Washington School of Medicine, Campus, Box 8502, 4444 Forest Park Ave., St. Louis, MO 63108, Telephone: (314)-268–1425. Fax: (314)-268–1410, <email>earhartg@wusm.wustl.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>6</day>
<month>8</month>
<year>2012</year>
</pub-date>
<pub-date pub-type="epub"><day>10</day>
<month>8</month>
<year>2012</year>
</pub-date>
<pub-date pub-type="ppub"><month>1</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>01</day>
<month>1</month>
<year>2014</year>
</pub-date>
<volume>19</volume>
<issue>1</issue>
<fpage>86</fpage>
<lpage>91</lpage>
<permissions><copyright-statement>© 2012 Elsevier Ltd. All rights reserved.</copyright-statement>
<copyright-year>2012</copyright-year>
</permissions>
<abstract><sec id="S1"><title>Background</title>
<p id="P2">Dopaminergic medications and subthalamic nucleus deep brain stimulation (STN-DBS) alleviate motor symptoms in Parkinson disease, but balance and gait are more variably affected. Balance reports are particularly inconsistent. Further, despite their prevalence in daily life, complex gait situations including backward and dual task gait are rarely studied. We aimed to assess how medications, STN-DBS, and both therapies combined affect balance and complex gait.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P3">Twelve people with Parkinson disease were evaluated OFF medication with STN-DBS OFF and ON as well as ON medication with STN-DBS OFF and ON. Motor impairment was measured with the Movement Disorder Society Unified Parkinson Disease Rating Scale motor section (MDS-UPDRS-III). The Mini-Balance Evaluations Systems Test, timed-up-and-go, and dual task timed-up-and-go measured balance and mobility. Preferred-pace forward, fast as possible, backward, dual task forward, and dual task backward gait were also analyzed.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P4">Medication improved MDS-UPDRS-III scores, dual task timed-up-and-go, and stride length across all gait tasks. STN-DBS improved MDS-UPDRS-III scores, balance scores, dual task timed-up-and-go, and stride length and velocity across all gait tasks. Medication and STN-DBS combined did not provide additional benefits over either therapy alone.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P5">Overall, dopaminergic medications and STN-DBS provided similar improvements in balance and gait tasks, although the effects of STN-DBS were stronger, potentially due to reductions in medication doses after surgery. Lack of synergistic effect of treatments may suggest both therapies improve balance and gait by influencing similar neural pathways.</p>
</sec>
</abstract>
<kwd-group><kwd>Parkinson Disease</kwd>
<kwd>Medication</kwd>
<kwd>Deep Brain Stimulation</kwd>
<kwd>Gait</kwd>
<kwd>Balance</kwd>
</kwd-group>
<funding-group><award-group><funding-source country="United States">National Institute of Child Health & Human Development : NICHD</funding-source>
<award-id>R01 HD056015 || HD</award-id>
</award-group>
</funding-group>
</article-meta>
</front>
</pmc>
</record>
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