Gait and balance in essential tremor: Variable effects of bilateral thalamic stimulation
Identifieur interne : 002294 ( Main/Exploration ); précédent : 002293; suivant : 002295Gait 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.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
- Adult, Aged, Deep Brain Stimulation (methods), Deep brain stimulation, Essential Tremor (epidemiology), Essential Tremor (physiopathology), Essential Tremor (therapy), Female, Gait Disorders, Neurologic (epidemiology), Gait Disorders, Neurologic (physiopathology), Gait Disorders, Neurologic (therapy), Humans, Locomotion, Male, Middle Aged, Nervous system diseases, Postural Balance (physiology), Severity of Illness Index, Thalamus (physiopathology), Treatment Outcome, Tremor, balance, deep brain stimulation, essential tremor, locomotion.
- MESH :
- epidemiology : Essential Tremor, Gait Disorders, Neurologic.
- methods : Deep Brain Stimulation.
- physiology : Postural Balance.
- physiopathology : Essential Tremor, Gait Disorders, Neurologic, Thalamus.
- therapy : Essential Tremor, Gait Disorders, Neurologic.
- Adult, Aged, Female, Humans, Male, Middle Aged, Severity of Illness Index, Treatment Outcome.
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:
- https://api.istex.fr/document/304074EB2F2A55773D5689243DB488E76E46531C/fulltext/pdf
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2882155
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)
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Le document en format XML
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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. 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