Gait and Balance Disorders in Parkinson's Disease : Impaired Active Braking of the Fall of Centre of Gravity
Identifieur interne : 000E68 ( PascalFrancis/Checkpoint ); précédent : 000E67; suivant : 000E69Gait and Balance Disorders in Parkinson's Disease : Impaired Active Braking of the Fall of Centre of Gravity
Auteurs : Nathalie Chastan [France] ; MANH CUONG DO [France] ; Fabrice Bonneville [France] ; Frédéric Torny [France] ; Frédéric Bloch [France] ; G. W. Max Westby [France] ; Didier Dormont [France] ; Yves Agid [France] ; Marie-Laure Welter [France]Source :
- Movement disorders [ 0885-3185 ] ; 2009.
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Abstract
Gait and balance disorders are common in Parkinson disease (PD), but its pathophysiology is still poorly understood. Step length, antero-posterior, and vertical velocities of the center of gravity (CG) during gait initiation were analyzed in 32 controls and 32 PD patients, with and without levodopa, using a force platform. Brain volumes and mesencephalic surface area were measured in PD patients. During the swing limb period, controls showed a fall in the CG, which was reversed before foot-contact indicating active braking of the CG fall. In PD patients, without levodopa, step length and velocity were significantly reduced and no braking occurred before foot-contact in 22 patients. With levodopa, step length and velocity increased in all patients and 7 patients improved their braking capacity. PD patients with normal braking (n = 17) had significantly lower gait and balance disorder scores and higher normalized-mesencephalic surface areas compared to patients with impaired braking (n = 15). The decreased step length and velocity, characteristic of PD, mainly result from degeneration of central dopaminergic systems. The markedly decreased braking capacity observed in half the PD patients contributes to their gait disorders and postural instability, perhaps as a result of nondopaminergic lesions, possibly at the mesencephalic level.
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aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Dormont, Didier" sort="Dormont, Didier" uniqKey="Dormont D" first="Didier" last="Dormont">Didier Dormont</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Université Pierre et Marie Curie-Paris 6, Institut Fédératif de Recherche (IFR-70)</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Service de Neuroradiologie, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>3 aut.</sZ><sZ>7 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type="city">Paris</settlement><region type="region" nuts="2">Île-de-France</region></placeName><orgName type="hospital" n="4">Hôpital de la Salpêtrière</orgName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Institut National de la Santé et de la Recherche Médicale, Unité 679</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName><placeName><settlement type="city">Paris</settlement><region type="region" nuts="2">Île-de-France</region></placeName><orgName type="hospital" n="4">Hôpital de la Salpêtrière</orgName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Université Pierre et Marie Curie-Paris 6, Institut Fédératif de Recherche (IFR-70)</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName><placeName><settlement type="city">Paris</settlement><region type="region" nuts="2">Île-de-France</region></placeName><orgName type="hospital" n="4">Hôpital de la Salpêtrière</orgName></affiliation></author><author><name sortKey="Welter, Marie Laure" sort="Welter, Marie Laure" uniqKey="Welter M" first="Marie-Laure" last="Welter">Marie-Laure Welter</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Fédération des Maladies du Système Nerveux, Centre d'Investigation Clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Institut National de la Santé et de la Recherche Médicale, Unité 679</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Université Pierre et Marie Curie-Paris 6, Institut Fédératif de Recherche (IFR-70)</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Groupe AVENIR-IFR 70, Institut National de la Santé et de la Recherche Médicale</s1><s2>Paris</s2><s3>FRA</s3><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">09-0104592</idno><date when="2009">2009</date><idno type="stanalyst">PASCAL 09-0104592 INIST</idno><idno type="RBID">Pascal:09-0104592</idno><idno type="wicri:Area/PascalFrancis/Corpus">000F74</idno><idno type="wicri:Area/PascalFrancis/Curation">001D45</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000E68</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Gait and Balance Disorders in Parkinson's Disease : Impaired Active Braking of the Fall of Centre of Gravity</title><author><name sortKey="Chastan, Nathalie" sort="Chastan, Nathalie" uniqKey="Chastan N" first="Nathalie" last="Chastan">Nathalie Chastan</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Fédération des Maladies du Système Nerveux, Centre d'Investigation Clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Institut National de la Santé et de la Recherche Médicale, Unité 679</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Université Pierre et Marie Curie-Paris 6, Institut Fédératif de Recherche (IFR-70)</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Service de Neurophysiologie, Centre Hospitalier Universitaire de Rouen</s1><s2>Rouen</s2><s3>FRA</s3><sZ>1 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Rouen</settlement></placeName></affiliation></author><author><name sortKey="Manh Cuong Do" sort="Manh Cuong Do" uniqKey="Manh Cuong Do" last="Manh Cuong Do">MANH CUONG DO</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Centre National de la Recherche Scientifique, FRE 2507. Institut des Systèmes Intelligents et de Robotique</s1><s2>Paris</s2><s3>FRA</s3><sZ>2 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>LCMP/UFR STAPS-Orsay, Université Paris-Sud 11</s1><s2>Orsay</s2><s3>FRA</s3><sZ>2 aut.</sZ></inist:fA14><country>France</country><placeName><region type="région" nuts="2">Île-de-France</region><settlement type="city">Orsay</settlement></placeName></affiliation></author><author><name sortKey="Bonneville, Fabrice" sort="Bonneville, Fabrice" uniqKey="Bonneville F" first="Fabrice" last="Bonneville">Fabrice Bonneville</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Université Pierre et Marie Curie-Paris 6, Institut Fédératif de Recherche (IFR-70)</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Service de Neuroradiologie, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>3 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Centre National de la Recherche et de la Santé, UPR640</s1><s2>Paris</s2><s3>FRA</s3><sZ>3 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Torny, Frederic" sort="Torny, Frederic" uniqKey="Torny F" first="Frédéric" last="Torny">Frédéric Torny</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Fédération des Maladies du Système Nerveux, Centre d'Investigation Clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Institut National de la Santé et de la Recherche Médicale, Unité 679</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Université Pierre et Marie Curie-Paris 6, Institut Fédératif de Recherche (IFR-70)</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Bloch, Frederic" sort="Bloch, Frederic" uniqKey="Bloch F" first="Frédéric" last="Bloch">Frédéric Bloch</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Fédération des Maladies du Système Nerveux, Centre d'Investigation Clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Institut National de la Santé et de la Recherche Médicale, Unité 679</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Université Pierre et Marie Curie-Paris 6, Institut Fédératif de Recherche (IFR-70)</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Westby, G W Max" sort="Westby, G W Max" uniqKey="Westby G" first="G. W. Max" last="Westby">G. W. Max Westby</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Fédération des Maladies du Système Nerveux, Centre d'Investigation Clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Institut National de la Santé et de la Recherche Médicale, Unité 679</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Université Pierre et Marie Curie-Paris 6, Institut Fédératif de Recherche (IFR-70)</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Dormont, Didier" sort="Dormont, Didier" uniqKey="Dormont D" first="Didier" last="Dormont">Didier Dormont</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Université Pierre et Marie Curie-Paris 6, Institut Fédératif de Recherche (IFR-70)</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Service de Neuroradiologie, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>3 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Centre National de la Recherche et de la Santé, UPR640</s1><s2>Paris</s2><s3>FRA</s3><sZ>3 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Agid, Yves" sort="Agid, Yves" uniqKey="Agid Y" first="Yves" last="Agid">Yves Agid</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Fédération des Maladies du Système Nerveux, Centre d'Investigation Clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName><placeName><settlement type="city">Paris</settlement><region type="region" nuts="2">Île-de-France</region></placeName><orgName type="hospital" n="4">Hôpital de la Salpêtrière</orgName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Institut National de la Santé et de la Recherche Médicale, Unité 679</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName><placeName><settlement type="city">Paris</settlement><region type="region" nuts="2">Île-de-France</region></placeName><orgName type="hospital" n="4">Hôpital de la Salpêtrière</orgName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Université Pierre et Marie Curie-Paris 6, Institut Fédératif de Recherche (IFR-70)</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName><placeName><settlement type="city">Paris</settlement><region type="region" nuts="2">Île-de-France</region></placeName><orgName type="hospital" n="4">Hôpital de la Salpêtrière</orgName></affiliation></author><author><name sortKey="Welter, Marie Laure" sort="Welter, Marie Laure" uniqKey="Welter M" first="Marie-Laure" last="Welter">Marie-Laure Welter</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Fédération des Maladies du Système Nerveux, Centre d'Investigation Clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Institut National de la Santé et de la Recherche Médicale, Unité 679</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Université Pierre et Marie Curie-Paris 6, Institut Fédératif de Recherche (IFR-70)</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Groupe AVENIR-IFR 70, Institut National de la Santé et de la Recherche Médicale</s1><s2>Paris</s2><s3>FRA</s3><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Equilibrium disorder</term><term>Gait disorder</term><term>Instability</term><term>Nervous system diseases</term><term>Nuclear magnetic resonance imaging</term><term>Parkinson disease</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Trouble de la marche</term><term>Trouble de l'équilibre</term><term>Maladie de Parkinson</term><term>Pathologie du système nerveux</term><term>Instabilité</term><term>Imagerie RMN</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Gait and balance disorders are common in Parkinson disease (PD), but its pathophysiology is still poorly understood. Step length, antero-posterior, and vertical velocities of the center of gravity (CG) during gait initiation were analyzed in 32 controls and 32 PD patients, with and without levodopa, using a force platform. Brain volumes and mesencephalic surface area were measured in PD patients. During the swing limb period, controls showed a fall in the CG, which was reversed before foot-contact indicating active braking of the CG fall. In PD patients, without levodopa, step length and velocity were significantly reduced and no braking occurred before foot-contact in 22 patients. With levodopa, step length and velocity increased in all patients and 7 patients improved their braking capacity. PD patients with normal braking (n = 17) had significantly lower gait and balance disorder scores and higher normalized-mesencephalic surface areas compared to patients with impaired braking (n = 15). The decreased step length and velocity, characteristic of PD, mainly result from degeneration of central dopaminergic systems. The markedly decreased braking capacity observed in half the PD patients contributes to their gait disorders and postural instability, perhaps as a result of nondopaminergic lesions, possibly at the mesencephalic level.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0885-3185</s0></fA01><fA03 i2="1"><s0>Mov. disord.</s0></fA03><fA05><s2>24</s2></fA05><fA06><s2>2</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Gait and Balance Disorders in Parkinson's Disease : Impaired Active Braking of the Fall of Centre of Gravity</s1></fA08><fA11 i1="01" i2="1"><s1>CHASTAN (Nathalie)</s1></fA11><fA11 i1="02" i2="1"><s1>MANH CUONG DO</s1></fA11><fA11 i1="03" i2="1"><s1>BONNEVILLE (Fabrice)</s1></fA11><fA11 i1="04" i2="1"><s1>TORNY (Frédéric)</s1></fA11><fA11 i1="05" i2="1"><s1>BLOCH (Frédéric)</s1></fA11><fA11 i1="06" i2="1"><s1>WESTBY (G. W. Max)</s1></fA11><fA11 i1="07" i2="1"><s1>DORMONT (Didier)</s1></fA11><fA11 i1="08" i2="1"><s1>AGID (Yves)</s1></fA11><fA11 i1="09" i2="1"><s1>WELTER (Marie-Laure)</s1></fA11><fA14 i1="01"><s1>Fédération des Maladies du Système Nerveux, Centre d'Investigation Clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></fA14><fA14 i1="02"><s1>Institut National de la Santé et de la Recherche Médicale, Unité 679</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></fA14><fA14 i1="03"><s1>Université Pierre et Marie Curie-Paris 6, Institut Fédératif de Recherche (IFR-70)</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></fA14><fA14 i1="04"><s1>Service de Neurophysiologie, Centre Hospitalier Universitaire de Rouen</s1><s2>Rouen</s2><s3>FRA</s3><sZ>1 aut.</sZ></fA14><fA14 i1="05"><s1>Centre National de la Recherche Scientifique, FRE 2507. Institut des Systèmes Intelligents et de Robotique</s1><s2>Paris</s2><s3>FRA</s3><sZ>2 aut.</sZ></fA14><fA14 i1="06"><s1>LCMP/UFR STAPS-Orsay, Université Paris-Sud 11</s1><s2>Orsay</s2><s3>FRA</s3><sZ>2 aut.</sZ></fA14><fA14 i1="07"><s1>Service de Neuroradiologie, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>3 aut.</sZ><sZ>7 aut.</sZ></fA14><fA14 i1="08"><s1>Centre National de la Recherche et de la Santé, UPR640</s1><s2>Paris</s2><s3>FRA</s3><sZ>3 aut.</sZ><sZ>7 aut.</sZ></fA14><fA14 i1="09"><s1>Groupe AVENIR-IFR 70, Institut National de la Santé et de la Recherche Médicale</s1><s2>Paris</s2><s3>FRA</s3><sZ>9 aut.</sZ></fA14><fA20><s1>188-195</s1></fA20><fA21><s1>2009</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>20953</s2><s5>354000184195990050</s5></fA43><fA44><s0>0000</s0><s1>© 2009 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>32 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>09-0104592</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Movement disorders</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>Gait and balance disorders are common in Parkinson disease (PD), but its pathophysiology is still poorly understood. Step length, antero-posterior, and vertical velocities of the center of gravity (CG) during gait initiation were analyzed in 32 controls and 32 PD patients, with and without levodopa, using a force platform. Brain volumes and mesencephalic surface area were measured in PD patients. During the swing limb period, controls showed a fall in the CG, which was reversed before foot-contact indicating active braking of the CG fall. In PD patients, without levodopa, step length and velocity were significantly reduced and no braking occurred before foot-contact in 22 patients. With levodopa, step length and velocity increased in all patients and 7 patients improved their braking capacity. PD patients with normal braking (n = 17) had significantly lower gait and balance disorder scores and higher normalized-mesencephalic surface areas compared to patients with impaired braking (n = 15). The decreased step length and velocity, characteristic of PD, mainly result from degeneration of central dopaminergic systems. The markedly decreased braking capacity observed in half the PD patients contributes to their gait disorders and postural instability, perhaps as a result of nondopaminergic lesions, possibly at the mesencephalic level.</s0></fC01><fC02 i1="01" i2="X"><s0>002B17</s0></fC02><fC02 i1="02" i2="X"><s0>002B17G</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Trouble de la marche</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Gait disorder</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Trastorno marcha</s0><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Trouble de l'équilibre</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Equilibrium disorder</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Trastorno equilibrio</s0><s5>02</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Maladie de Parkinson</s0><s2>NM</s2><s5>03</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Parkinson disease</s0><s2>NM</s2><s5>03</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Parkinson enfermedad</s0><s2>NM</s2><s5>03</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Pathologie du système nerveux</s0><s5>04</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Nervous system diseases</s0><s5>04</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Sistema nervioso patología</s0><s5>04</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Instabilité</s0><s5>09</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Instability</s0><s5>09</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Inestabilidad</s0><s5>09</s5></fC03><fC03 i1="06" i2="X" l="FRE"><s0>Imagerie RMN</s0><s5>10</s5></fC03><fC03 i1="06" i2="X" l="ENG"><s0>Nuclear magnetic resonance imaging</s0><s5>10</s5></fC03><fC03 i1="06" i2="X" l="SPA"><s0>Imaginería RMN</s0><s5>10</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Pathologie ORL</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="ENG"><s0>ENT disease</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="SPA"><s0>ORL patología</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Pathologie de l'encéphale</s0><s5>39</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Cerebral disorder</s0><s5>39</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Encéfalo patología</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="FRE"><s0>Syndrome extrapyramidal</s0><s5>40</s5></fC07><fC07 i1="03" i2="X" l="ENG"><s0>Extrapyramidal syndrome</s0><s5>40</s5></fC07><fC07 i1="03" i2="X" l="SPA"><s0>Extrapiramidal síndrome</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="FRE"><s0>Maladie dégénérative</s0><s5>41</s5></fC07><fC07 i1="04" i2="X" l="ENG"><s0>Degenerative disease</s0><s5>41</s5></fC07><fC07 i1="04" i2="X" l="SPA"><s0>Enfermedad degenerativa</s0><s5>41</s5></fC07><fC07 i1="05" i2="X" l="FRE"><s0>Pathologie du système nerveux central</s0><s5>42</s5></fC07><fC07 i1="05" i2="X" l="ENG"><s0>Central nervous system disease</s0><s5>42</s5></fC07><fC07 i1="05" i2="X" l="SPA"><s0>Sistema nervosio central patología</s0><s5>42</s5></fC07><fN21><s1>075</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard></inist><affiliations><list><country><li>France</li></country><region><li>Île-de-France</li></region><settlement><li>Orsay</li><li>Paris</li><li>Rouen</li></settlement><orgName><li>Hôpital de la Salpêtrière</li></orgName></list><tree><country name="France"><noRegion><name sortKey="Chastan, Nathalie" sort="Chastan, Nathalie" uniqKey="Chastan N" first="Nathalie" last="Chastan">Nathalie Chastan</name></noRegion><name sortKey="Agid, Yves" sort="Agid, Yves" uniqKey="Agid Y" first="Yves" last="Agid">Yves Agid</name><name sortKey="Agid, Yves" sort="Agid, Yves" uniqKey="Agid Y" first="Yves" last="Agid">Yves Agid</name><name sortKey="Agid, Yves" sort="Agid, Yves" uniqKey="Agid Y" first="Yves" last="Agid">Yves Agid</name><name sortKey="Bloch, Frederic" sort="Bloch, Frederic" uniqKey="Bloch F" first="Frédéric" last="Bloch">Frédéric Bloch</name><name sortKey="Bloch, Frederic" sort="Bloch, Frederic" uniqKey="Bloch F" first="Frédéric" last="Bloch">Frédéric Bloch</name><name sortKey="Bloch, Frederic" sort="Bloch, Frederic" uniqKey="Bloch F" first="Frédéric" last="Bloch">Frédéric Bloch</name><name sortKey="Bonneville, Fabrice" sort="Bonneville, Fabrice" uniqKey="Bonneville F" first="Fabrice" last="Bonneville">Fabrice Bonneville</name><name sortKey="Bonneville, Fabrice" sort="Bonneville, Fabrice" uniqKey="Bonneville F" first="Fabrice" last="Bonneville">Fabrice Bonneville</name><name sortKey="Bonneville, Fabrice" sort="Bonneville, Fabrice" uniqKey="Bonneville F" first="Fabrice" last="Bonneville">Fabrice Bonneville</name><name sortKey="Chastan, Nathalie" sort="Chastan, Nathalie" uniqKey="Chastan N" first="Nathalie" last="Chastan">Nathalie Chastan</name><name sortKey="Chastan, Nathalie" sort="Chastan, Nathalie" uniqKey="Chastan N" first="Nathalie" last="Chastan">Nathalie Chastan</name><name sortKey="Chastan, Nathalie" sort="Chastan, Nathalie" uniqKey="Chastan N" first="Nathalie" last="Chastan">Nathalie Chastan</name><name sortKey="Dormont, Didier" sort="Dormont, Didier" uniqKey="Dormont D" first="Didier" last="Dormont">Didier Dormont</name><name sortKey="Dormont, Didier" sort="Dormont, Didier" uniqKey="Dormont D" first="Didier" last="Dormont">Didier Dormont</name><name sortKey="Dormont, Didier" sort="Dormont, Didier" uniqKey="Dormont D" first="Didier" last="Dormont">Didier Dormont</name><name sortKey="Manh Cuong Do" sort="Manh Cuong Do" uniqKey="Manh Cuong Do" last="Manh Cuong Do">MANH CUONG DO</name><name sortKey="Manh Cuong Do" sort="Manh Cuong Do" uniqKey="Manh Cuong Do" last="Manh Cuong Do">MANH CUONG DO</name><name sortKey="Torny, Frederic" sort="Torny, Frederic" uniqKey="Torny F" first="Frédéric" last="Torny">Frédéric Torny</name><name sortKey="Torny, Frederic" sort="Torny, Frederic" uniqKey="Torny F" first="Frédéric" last="Torny">Frédéric Torny</name><name sortKey="Torny, Frederic" sort="Torny, Frederic" uniqKey="Torny F" first="Frédéric" last="Torny">Frédéric Torny</name><name sortKey="Welter, Marie Laure" sort="Welter, Marie Laure" uniqKey="Welter M" first="Marie-Laure" last="Welter">Marie-Laure Welter</name><name sortKey="Welter, Marie Laure" sort="Welter, Marie Laure" uniqKey="Welter M" first="Marie-Laure" last="Welter">Marie-Laure Welter</name><name sortKey="Welter, Marie Laure" sort="Welter, Marie Laure" uniqKey="Welter M" first="Marie-Laure" last="Welter">Marie-Laure Welter</name><name sortKey="Welter, Marie Laure" sort="Welter, Marie Laure" uniqKey="Welter M" first="Marie-Laure" last="Welter">Marie-Laure Welter</name><name sortKey="Westby, G W Max" sort="Westby, G W Max" uniqKey="Westby G" first="G. W. Max" last="Westby">G. W. Max Westby</name><name sortKey="Westby, G W Max" sort="Westby, G W Max" uniqKey="Westby G" first="G. W. Max" last="Westby">G. W. Max Westby</name><name sortKey="Westby, G W Max" sort="Westby, G W Max" uniqKey="Westby G" first="G. W. Max" last="Westby">G. W. Max Westby</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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