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The effect of deep brain stimulation randomized by site on balance in Parkinson’s disease

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The effect of deep brain stimulation randomized by site on balance in Parkinson’s disease

Auteurs : R. J. St George [États-Unis] ; P. Carlson-Kuhta [États-Unis] ; J. G. Nutt [États-Unis] ; P. Hogarth [États-Unis] ; K. J. Burchiel [États-Unis] ; F. B. Horak [États-Unis]

Source :

Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2014.

RBID : PMC:4057940

Abstract

Background

The effect of the surgical site of Deep Brain Stimulation (DBS) on balance and gait in Parkinson’s Disease (PD) is uncertain. This is the first double-blind study of subjects randomized to either the Subthalamic Nucleus (STN, N=14) or Globus Pallidus interna (GPi, N=14) who were assessed on a range of clinical balance measures.

Methods

Balance testing occurred before and 6 months post-surgery. A control PD group was tested over the same time period without surgery (N=9). All subjects were tested on and off medication and DBS subjects were also tested on and off DBS. The Postural Instability and Gait Disability items of the Unified Parkinson’s Disease Rating Scale and additional functional tests we call the Balance and Gait scale were assessed. Activities of Balance Confidence and Activities of Daily Living questionnaires were also recorded.

Results

Balance was not different between the best-treated states before and after DBS surgery for both sites. Switching DBS on improved balance scores and scores further improved with medication compared to the off state. The GPi group showed improved performance in the post-surgery off state and better ratings of balance confidence after surgery compared to the STN group.

Conclusions

Clinical measures of balance function for both the STN and GPi sites showed that balance did not improve beyond the best medically-treated state prior to surgery. Both clinical balance testing in the OFF/OFF state and self-reported balance confidence after surgery showed better performance in the GPi than the STN group.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4057940

DOI: 10.1002/mds.25831
PubMed: 24532106
PubMed Central: 4057940

Affiliations:

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<author><name sortKey="St George, R J" sort="St George, R J" uniqKey="St George R" first="R. J." last="St George">R. J. St George</name>
<affiliation wicri:level="4"><nlm:aff id="A1">Department of Neurology, Oregon Health & Science University, Portland, Oregon, USA</nlm:aff>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">The effect of the surgical site of Deep Brain Stimulation (DBS) on balance and gait in Parkinson’s Disease (PD) is uncertain. This is the first double-blind study of subjects randomized to either the Subthalamic Nucleus (STN, N=14) or Globus Pallidus interna (GPi, N=14) who were assessed on a range of clinical balance measures.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">Balance testing occurred before and 6 months post-surgery. A control PD group was tested over the same time period without surgery (N=9). All subjects were tested on and off medication and DBS subjects were also tested on and off DBS. The Postural Instability and Gait Disability items of the Unified Parkinson’s Disease Rating Scale and additional functional tests we call the Balance and Gait scale were assessed. Activities of Balance Confidence and Activities of Daily Living questionnaires were also recorded.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Balance was not different between the best-treated states before and after DBS surgery for both sites. Switching DBS on improved balance scores and scores further improved with medication compared to the off state. The GPi group showed improved performance in the post-surgery off state and better ratings of balance confidence after surgery compared to the STN group.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Clinical measures of balance function for both the STN and GPi sites showed that balance did not improve beyond the best medically-treated state prior to surgery. Both clinical balance testing in the OFF/OFF state and self-reported balance confidence after surgery showed better performance in the GPi than the STN group.</p>
</sec>
</div>
</front>
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<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">8610688</journal-id>
<journal-id journal-id-type="pubmed-jr-id">5937</journal-id>
<journal-id journal-id-type="nlm-ta">Mov Disord</journal-id>
<journal-id journal-id-type="iso-abbrev">Mov. Disord.</journal-id>
<journal-title-group><journal-title>Movement disorders : official journal of the Movement Disorder Society</journal-title>
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<issn pub-type="epub">1531-8257</issn>
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<article-meta><article-id pub-id-type="pmid">24532106</article-id>
<article-id pub-id-type="pmc">4057940</article-id>
<article-id pub-id-type="doi">10.1002/mds.25831</article-id>
<article-id pub-id-type="manuscript">NIHMS558846</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
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</article-categories>
<title-group><article-title>The effect of deep brain stimulation randomized by site on balance in Parkinson’s disease</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>St George</surname>
<given-names>R.J.</given-names>
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<contrib contrib-type="author"><name><surname>Carlson-Kuhta</surname>
<given-names>P.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Nutt</surname>
<given-names>J.G.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Hogarth</surname>
<given-names>P.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Burchiel</surname>
<given-names>K.J.</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Horak</surname>
<given-names>F.B.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
Department of Neurology, Oregon Health & Science University, Portland, Oregon, USA</aff>
<aff id="A2"><label>2</label>
Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon, USA</aff>
<author-notes><corresp id="FN1">Corresponding Author: Dr. Rebecca J St George, <email>r.stgeorge@neura.edu.au</email>
, telephone: +44 2034488788</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>3</day>
<month>3</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="epub"><day>14</day>
<month>2</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="ppub"><month>6</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>01</day>
<month>6</month>
<year>2015</year>
</pub-date>
<volume>29</volume>
<issue>7</issue>
<fpage>949</fpage>
<lpage>953</lpage>
<pmc-comment>elocation-id from pubmed: 10.1002/mds.25831</pmc-comment>
      <abstract><sec id="S1"><title>Background</title>
<p id="P1">The effect of the surgical site of Deep Brain Stimulation (DBS) on balance and gait in Parkinson’s Disease (PD) is uncertain. This is the first double-blind study of subjects randomized to either the Subthalamic Nucleus (STN, N=14) or Globus Pallidus interna (GPi, N=14) who were assessed on a range of clinical balance measures.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">Balance testing occurred before and 6 months post-surgery. A control PD group was tested over the same time period without surgery (N=9). All subjects were tested on and off medication and DBS subjects were also tested on and off DBS. The Postural Instability and Gait Disability items of the Unified Parkinson’s Disease Rating Scale and additional functional tests we call the Balance and Gait scale were assessed. Activities of Balance Confidence and Activities of Daily Living questionnaires were also recorded.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Balance was not different between the best-treated states before and after DBS surgery for both sites. Switching DBS on improved balance scores and scores further improved with medication compared to the off state. The GPi group showed improved performance in the post-surgery off state and better ratings of balance confidence after surgery compared to the STN group.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Clinical measures of balance function for both the STN and GPi sites showed that balance did not improve beyond the best medically-treated state prior to surgery. Both clinical balance testing in the OFF/OFF state and self-reported balance confidence after surgery showed better performance in the GPi than the STN group.</p>
</sec>
</abstract>
<kwd-group><kwd>Parkinson’s disease</kwd>
<kwd>DBS</kwd>
<kwd>postural control</kwd>
<kwd>clinical assessment</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>États-Unis</li>
</country>
<region><li>Oregon</li>
</region>
<settlement><li>Portland</li>
</settlement>
<orgName><li>Université des sciences et de la médecine de l'Oregon</li>
</orgName>
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<tree><country name="États-Unis"><region name="Oregon"><name sortKey="St George, R J" sort="St George, R J" uniqKey="St George R" first="R. J." last="St George">R. J. St George</name>
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<name sortKey="Burchiel, K J" sort="Burchiel, K J" uniqKey="Burchiel K" first="K. J." last="Burchiel">K. J. Burchiel</name>
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<name sortKey="Hogarth, P" sort="Hogarth, P" uniqKey="Hogarth P" first="P." last="Hogarth">P. Hogarth</name>
<name sortKey="Horak, F B" sort="Horak, F B" uniqKey="Horak F" first="F. B." last="Horak">F. B. Horak</name>
<name sortKey="Nutt, J G" sort="Nutt, J G" uniqKey="Nutt J" first="J. G." last="Nutt">J. G. Nutt</name>
</country>
</tree>
</affiliations>
</record>

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	Movement Disorders (revue)
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Movement Disorders (revue)

The effect of deep brain stimulation randomized by site on balance in Parkinson’s disease

The effect of deep brain stimulation randomized by site on balance in Parkinson’s disease

Source :

Abstract

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Le document en format XML

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Pour générer des pages wiki