Gait and balance in essential tremor: Variable effects of bilateral thalamic stimulation
Identifieur interne : 000E96 ( Istex/Checkpoint ); précédent : 000E95; suivant : 000E97Gait and balance in essential tremor: Variable effects of bilateral thalamic stimulation
Auteurs : Gammon M. Earhart [États-Unis] ; B. Ruth Clark [États-Unis] ; Samer D. Tabbal [États-Unis] ; Joel S. Perlmutter [États-Unis]Source :
- Movement Disorders [ 0885-3185 ] ; 2009-02-15.
English descriptors
- KwdEn :
Abstract
Essential tremor (ET) is a multi‐faceted condition best known for postural and action tremor but also may include disordered gait and postural instability. Deep brain stimulation (DBS) of the ventral intermediate nucleus (VIM) of the thalamus provides substantial tremor reduction yet some patients with bilateral VIM DBS have gait and balance impairment. This study examines gait and balance performance in 13 participants with ET who have bilateral VIM DBS compared with a matched control group. Participants with ET were tested with their stimulators off (DBS OFF) and on (DBS ON). For both standard and tandem walking, participants with ET walked significantly more slowly than controls, with significantly lower cadence, spending a lower percentage of the gait cycle in single limb support and a higher percentage in double support compared with controls. Participants with ET also had significantly lower tandem and one leg stance times, Berg balance scores, balance confidence, and required significantly greater time to perform the Timed Up‐and‐Go relative to controls. There were no significant differences in any gait or balance measures in the DBS OFF versus DBS ON conditions, but the effects of DBS on gait and balance were highly variable among individuals. Future studies are needed to determine why some individuals experience gait and balance difficulties after bilateral thalamic DBS and others do not. A better understanding of the mechanisms underlying gait and balance impairments in those with bilateral DBS is critical to reduce falls and fractures in this group. © 2008 Movement Disorder Society
Url:
DOI: 10.1002/mds.22356
Affiliations:
- États-Unis
- Missouri (État)
- Saint-Louis (Missouri)
- Université Washington de Saint-Louis, École de médecine (Université Washington de Saint-Louis)
Links toward previous steps (curation, corpus...)
Links to Exploration step
ISTEX:304074EB2F2A55773D5689243DB488E76E46531CLe document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Gait and balance in essential tremor: Variable effects of bilateral thalamic stimulation</title>
<author><name sortKey="Earhart, Gammon M" sort="Earhart, Gammon M" uniqKey="Earhart G" first="Gammon M." last="Earhart">Gammon M. Earhart</name>
<affiliation><country>États-Unis</country>
<placeName><settlement type="city">Saint-Louis (Missouri)</settlement>
<region type="state">Missouri (État)</region>
</placeName>
<orgName type="university" n="3">École de médecine (Université Washington de Saint-Louis)</orgName>
<orgName type="institution">Université Washington de Saint-Louis</orgName>
</affiliation>
</author>
<author><name sortKey="Clark, B Ruth" sort="Clark, B Ruth" uniqKey="Clark B" first="B. Ruth" last="Clark">B. Ruth Clark</name>
</author>
<author><name sortKey="Tabbal, Samer D" sort="Tabbal, Samer D" uniqKey="Tabbal S" first="Samer D." last="Tabbal">Samer D. Tabbal</name>
</author>
<author><name sortKey="Perlmutter, Joel S" sort="Perlmutter, Joel S" uniqKey="Perlmutter J" first="Joel S." last="Perlmutter">Joel S. Perlmutter</name>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">ISTEX</idno>
<idno type="RBID">ISTEX:304074EB2F2A55773D5689243DB488E76E46531C</idno>
<date when="2009" year="2009">2009</date>
<idno type="doi">10.1002/mds.22356</idno>
<idno type="url">https://api.istex.fr/document/304074EB2F2A55773D5689243DB488E76E46531C/fulltext/pdf</idno>
<idno type="wicri:Area/Istex/Corpus">001469</idno>
<idno type="wicri:Area/Istex/Curation">001469</idno>
<idno type="wicri:Area/Istex/Checkpoint">000E96</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Gait and balance in essential tremor: Variable effects of bilateral thalamic stimulation</title>
<author><name sortKey="Earhart, Gammon M" sort="Earhart, Gammon M" uniqKey="Earhart G" first="Gammon M." last="Earhart">Gammon M. Earhart</name>
<affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Program in Physical Therapy, Washington University, St. Louis, Missouri</wicri:regionArea>
<placeName><region type="state">Missouri (État)</region>
</placeName>
<placeName><settlement type="city">Saint-Louis (Missouri)</settlement>
<region type="state">Missouri (État)</region>
</placeName>
<orgName type="university" n="3">École de médecine (Université Washington de Saint-Louis)</orgName>
<orgName type="institution">Université Washington de Saint-Louis</orgName>
</affiliation>
<affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Anatomy and Neurobiology, Washington University, St. Louis, Missouri</wicri:regionArea>
<placeName><region type="state">Missouri (État)</region>
</placeName>
<placeName><settlement type="city">Saint-Louis (Missouri)</settlement>
<region type="state">Missouri (État)</region>
</placeName>
<orgName type="university" n="3">École de médecine (Université Washington de Saint-Louis)</orgName>
<orgName type="institution">Université Washington de Saint-Louis</orgName>
</affiliation>
<affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, Washington University, St. Louis, Missouri</wicri:regionArea>
<placeName><region type="state">Missouri (État)</region>
</placeName>
<placeName><settlement type="city">Saint-Louis (Missouri)</settlement>
<region type="state">Missouri (État)</region>
</placeName>
<orgName type="university" n="3">École de médecine (Université Washington de Saint-Louis)</orgName>
<orgName type="institution">Université Washington de Saint-Louis</orgName>
</affiliation>
</author>
<author><name sortKey="Clark, B Ruth" sort="Clark, B Ruth" uniqKey="Clark B" first="B. Ruth" last="Clark">B. Ruth Clark</name>
<affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Program in Physical Therapy, Washington University, St. Louis, Missouri</wicri:regionArea>
<placeName><region type="state">Missouri (État)</region>
</placeName>
</affiliation>
<affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, Washington University, St. Louis, Missouri</wicri:regionArea>
<placeName><region type="state">Missouri (État)</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Tabbal, Samer D" sort="Tabbal, Samer D" uniqKey="Tabbal S" first="Samer D." last="Tabbal">Samer D. Tabbal</name>
<affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, Washington University, St. Louis, Missouri</wicri:regionArea>
<placeName><region type="state">Missouri (État)</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Perlmutter, Joel S" sort="Perlmutter, Joel S" uniqKey="Perlmutter J" first="Joel S." last="Perlmutter">Joel S. Perlmutter</name>
<affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Program in Physical Therapy, Washington University, St. Louis, Missouri</wicri:regionArea>
<placeName><region type="state">Missouri (État)</region>
</placeName>
</affiliation>
<affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Anatomy and Neurobiology, Washington University, St. Louis, Missouri</wicri:regionArea>
<placeName><region type="state">Missouri (État)</region>
</placeName>
</affiliation>
<affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, Washington University, St. Louis, Missouri</wicri:regionArea>
<placeName><region type="state">Missouri (État)</region>
</placeName>
</affiliation>
<affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Radiology, Washington University, St. Louis, Missouri</wicri:regionArea>
<placeName><region type="state">Missouri (État)</region>
</placeName>
</affiliation>
</author>
</analytic>
<monogr></monogr>
<series><title level="j">Movement Disorders</title>
<title level="j" type="abbrev">Mov. Disord.</title>
<idno type="ISSN">0885-3185</idno>
<idno type="eISSN">1531-8257</idno>
<imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher>
<pubPlace>Hoboken</pubPlace>
<date type="published" when="2009-02-15">2009-02-15</date>
<biblScope unit="vol">24</biblScope>
<biblScope unit="issue">3</biblScope>
<biblScope unit="page" from="386">386</biblScope>
<biblScope unit="page" to="391">391</biblScope>
</imprint>
<idno type="ISSN">0885-3185</idno>
</series>
<idno type="istex">304074EB2F2A55773D5689243DB488E76E46531C</idno>
<idno type="DOI">10.1002/mds.22356</idno>
<idno type="ArticleID">MDS22356</idno>
</biblStruct>
</sourceDesc>
<seriesStmt><idno type="ISSN">0885-3185</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>balance</term>
<term>deep brain stimulation</term>
<term>essential tremor</term>
<term>locomotion</term>
</keywords>
</textClass>
<langUsage><language ident="en">en</language>
</langUsage>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">Essential tremor (ET) is a multi‐faceted condition best known for postural and action tremor but also may include disordered gait and postural instability. Deep brain stimulation (DBS) of the ventral intermediate nucleus (VIM) of the thalamus provides substantial tremor reduction yet some patients with bilateral VIM DBS have gait and balance impairment. This study examines gait and balance performance in 13 participants with ET who have bilateral VIM DBS compared with a matched control group. Participants with ET were tested with their stimulators off (DBS OFF) and on (DBS ON). For both standard and tandem walking, participants with ET walked significantly more slowly than controls, with significantly lower cadence, spending a lower percentage of the gait cycle in single limb support and a higher percentage in double support compared with controls. Participants with ET also had significantly lower tandem and one leg stance times, Berg balance scores, balance confidence, and required significantly greater time to perform the Timed Up‐and‐Go relative to controls. There were no significant differences in any gait or balance measures in the DBS OFF versus DBS ON conditions, but the effects of DBS on gait and balance were highly variable among individuals. Future studies are needed to determine why some individuals experience gait and balance difficulties after bilateral thalamic DBS and others do not. A better understanding of the mechanisms underlying gait and balance impairments in those with bilateral DBS is critical to reduce falls and fractures in this group. © 2008 Movement Disorder Society</div>
</front>
</TEI>
<affiliations><list><country><li>États-Unis</li>
</country>
<region><li>Missouri (État)</li>
</region>
<settlement><li>Saint-Louis (Missouri)</li>
</settlement>
<orgName><li>Université Washington de Saint-Louis</li>
<li>École de médecine (Université Washington de Saint-Louis)</li>
</orgName>
</list>
<tree><country name="États-Unis"><region name="Missouri (État)"><name sortKey="Earhart, Gammon M" sort="Earhart, Gammon M" uniqKey="Earhart G" first="Gammon M." last="Earhart">Gammon M. Earhart</name>
</region>
<name sortKey="Clark, B Ruth" sort="Clark, B Ruth" uniqKey="Clark B" first="B. Ruth" last="Clark">B. Ruth Clark</name>
<name sortKey="Clark, B Ruth" sort="Clark, B Ruth" uniqKey="Clark B" first="B. Ruth" last="Clark">B. Ruth Clark</name>
<name sortKey="Earhart, Gammon M" sort="Earhart, Gammon M" uniqKey="Earhart G" first="Gammon M." last="Earhart">Gammon M. Earhart</name>
<name sortKey="Earhart, Gammon M" sort="Earhart, Gammon M" uniqKey="Earhart G" first="Gammon M." last="Earhart">Gammon M. Earhart</name>
<name sortKey="Perlmutter, Joel S" sort="Perlmutter, Joel S" uniqKey="Perlmutter J" first="Joel S." last="Perlmutter">Joel S. Perlmutter</name>
<name sortKey="Perlmutter, Joel S" sort="Perlmutter, Joel S" uniqKey="Perlmutter J" first="Joel S." last="Perlmutter">Joel S. Perlmutter</name>
<name sortKey="Perlmutter, Joel S" sort="Perlmutter, Joel S" uniqKey="Perlmutter J" first="Joel S." last="Perlmutter">Joel S. Perlmutter</name>
<name sortKey="Perlmutter, Joel S" sort="Perlmutter, Joel S" uniqKey="Perlmutter J" first="Joel S." last="Perlmutter">Joel S. Perlmutter</name>
<name sortKey="Tabbal, Samer D" sort="Tabbal, Samer D" uniqKey="Tabbal S" first="Samer D." last="Tabbal">Samer D. Tabbal</name>
</country>
</tree>
</affiliations>
</record>
Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Santé/explor/MovDisordV3/Data/Istex/Checkpoint
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000E96 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Istex/Checkpoint/biblio.hfd -nk 000E96 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien |wiki= Wicri/Santé |area= MovDisordV3 |flux= Istex |étape= Checkpoint |type= RBID |clé= ISTEX:304074EB2F2A55773D5689243DB488E76E46531C |texte= Gait and balance in essential tremor: Variable effects of bilateral thalamic stimulation }}
![]() | This area was generated with Dilib version V0.6.23. | ![]() |