Different effects of unilateral versus bilateral subthalamic nucleus stimulation on walking and reaching in Parkinson's disease
Identifieur interne : 004127 ( Main/Exploration ); précédent : 004126; suivant : 004128Different effects of unilateral versus bilateral subthalamic nucleus stimulation on walking and reaching in Parkinson's disease
Auteurs : Amy J. Bastian [États-Unis] ; Valerie E. Kelly [États-Unis] ; Fredy J. Revilla [États-Unis] ; Joel S. Perlmutter [États-Unis] ; Jonathan W. Mink [États-Unis]Source :
- Movement Disorders [ 0885-3185 ] ; 2003-09.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
- Adult, Aged, Bilateral, Biomechanical Phenomena, Comparative study, Electric Stimulation Therapy, Electrical stimulus, Electrodes, Implanted, Female, Gait, Human, Humans, Instrumentation therapy, Male, Middle Aged, Movement, Parkinson Disease (physiopathology), Parkinson Disease (surgery), Parkinson disease, Parkinson's disease, Subthalamic Nucleus (surgery), Subthalamic nucleus, Technique, Treatment Outcome, Unilateral, Walking, deep brain stimulation, gait.
- MESH :
- physiopathology : Parkinson Disease.
- surgery : Parkinson Disease, Subthalamic Nucleus.
- Adult, Aged, Biomechanical Phenomena, Electric Stimulation Therapy, Electrodes, Implanted, Female, Gait, Humans, Male, Middle Aged, Movement, Treatment Outcome, Walking.
Abstract
The purpose of this study was to determine the effects of unilateral versus bilateral subthalamic nucleus (STN) stimulation on quantitative measures of walking and reaching in Parkinson's disease (PD). We used kinematic measures and the Unified Parkinson's Disease Rating Scale (UPDRS) motor subscale (subscale III) to evaluate the movement of 6 people with PD who had bilateral STN stimulators implanted for at least 6 months and withheld their anti‐parkinson medication for at least 8 hours. Subjects were studied with both stimulators off, one on, and both on. Kinematic data were collected as subjects walked, reached to a target, and were rated using the UPDRS motor subscale. STN stimulation improved walking speed and stride length, with the greatest benefit from bilateral stimulation. Reaching speed was improved by unilateral STN stimulation alone, with no additive effect of bilateral stimulation. UPDRS motor subscale ratings paralleled the kinematic findings. STN stimulation did not restore PD subjects' movements to the level of age‐matched controls. Overall, these results provide further evidence that the basal ganglia pathways involved in control of walking and reaching may be distinct. We speculate that basal ganglia may influence walking through bilateral pedunculopontine projections and reaching through ipsilateral thalamocortical projections. Our findings also suggest that maximal improvement of walking requires bilateral rather than unilateral STN stimulation. © 2003 Movement Disorder Society
Url:
DOI: 10.1002/mds.10493
Affiliations:
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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="2003-09">2003-09</date><biblScope unit="vol">18</biblScope><biblScope unit="issue">9</biblScope><biblScope unit="page" from="1000">1000</biblScope><biblScope unit="page" to="1007">1007</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">5A88F9142287052F71317A64FDF3F7FB1CDD50A9</idno><idno type="DOI">10.1002/mds.10493</idno><idno type="ArticleID">MDS10493</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Bilateral</term><term>Biomechanical Phenomena</term><term>Comparative study</term><term>Electric Stimulation Therapy</term><term>Electrical stimulus</term><term>Electrodes, Implanted</term><term>Female</term><term>Gait</term><term>Human</term><term>Humans</term><term>Instrumentation therapy</term><term>Male</term><term>Middle Aged</term><term>Movement</term><term>Parkinson Disease (physiopathology)</term><term>Parkinson Disease (surgery)</term><term>Parkinson disease</term><term>Parkinson's disease</term><term>Subthalamic Nucleus (surgery)</term><term>Subthalamic nucleus</term><term>Technique</term><term>Treatment Outcome</term><term>Unilateral</term><term>Walking</term><term>deep brain stimulation</term><term>gait</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Parkinson Disease</term><term>Subthalamic Nucleus</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Biomechanical Phenomena</term><term>Electric Stimulation Therapy</term><term>Electrodes, Implanted</term><term>Female</term><term>Gait</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Movement</term><term>Treatment Outcome</term><term>Walking</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Bilatéral</term><term>Etude comparative</term><term>Homme</term><term>Marche à pied</term><term>Noyau sousthalamique</term><term>Parkinson maladie</term><term>Stimulus électrique</term><term>Technique</term><term>Traitement instrumental</term><term>Unilatéral</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The purpose of this study was to determine the effects of unilateral versus bilateral subthalamic nucleus (STN) stimulation on quantitative measures of walking and reaching in Parkinson's disease (PD). We used kinematic measures and the Unified Parkinson's Disease Rating Scale (UPDRS) motor subscale (subscale III) to evaluate the movement of 6 people with PD who had bilateral STN stimulators implanted for at least 6 months and withheld their anti‐parkinson medication for at least 8 hours. Subjects were studied with both stimulators off, one on, and both on. Kinematic data were collected as subjects walked, reached to a target, and were rated using the UPDRS motor subscale. STN stimulation improved walking speed and stride length, with the greatest benefit from bilateral stimulation. Reaching speed was improved by unilateral STN stimulation alone, with no additive effect of bilateral stimulation. UPDRS motor subscale ratings paralleled the kinematic findings. STN stimulation did not restore PD subjects' movements to the level of age‐matched controls. Overall, these results provide further evidence that the basal ganglia pathways involved in control of walking and reaching may be distinct. We speculate that basal ganglia may influence walking through bilateral pedunculopontine projections and reaching through ipsilateral thalamocortical projections. Our findings also suggest that maximal improvement of walking requires bilateral rather than unilateral STN stimulation. © 2003 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Maryland</li><li>Missouri (État)</li><li>État de New York</li></region></list><tree><country name="États-Unis"><region name="Maryland"><name sortKey="Bastian, Amy J" sort="Bastian, Amy J" uniqKey="Bastian A" first="Amy J." last="Bastian">Amy J. Bastian</name></region><name sortKey="Bastian, Amy J" sort="Bastian, Amy J" uniqKey="Bastian A" first="Amy J." last="Bastian">Amy J. Bastian</name><name sortKey="Bastian, Amy J" sort="Bastian, Amy J" uniqKey="Bastian A" first="Amy J." last="Bastian">Amy J. Bastian</name><name sortKey="Kelly, Valerie E" sort="Kelly, Valerie E" uniqKey="Kelly V" first="Valerie E." last="Kelly">Valerie E. Kelly</name><name sortKey="Mink, Jonathan W" sort="Mink, Jonathan W" uniqKey="Mink J" first="Jonathan W." last="Mink">Jonathan W. Mink</name><name sortKey="Perlmutter, Joel S" sort="Perlmutter, Joel S" uniqKey="Perlmutter J" first="Joel S." last="Perlmutter">Joel S. Perlmutter</name><name sortKey="Revilla, Fredy J" sort="Revilla, Fredy J" uniqKey="Revilla F" first="Fredy J." last="Revilla">Fredy J. Revilla</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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