Effects of subthalamic nucleus stimulation and levodopa treatment on gait abnormalities in Parkinson disease
Identifieur interne : 003262 ( Main/Exploration ); précédent : 003261; suivant : 003263Effects of subthalamic nucleus stimulation and levodopa treatment on gait abnormalities in Parkinson disease
Auteurs : Pierre Krystkowiak [France] ; Jean-Louis Blatt [France] ; Jean-Louis Bourriez [France] ; Alain Duhamel [France] ; Miriam Perina [France] ; Serge Blond [France] ; Jean-Daniel Guieu [France] ; Alain Destée [France] ; Luc Defebvre [France]Source :
- Archives of neurology : (Chicago) [ 0003-9942 ] ; 2003.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Adulte.
English descriptors
- KwdEn :
- Adult, Antiparkinson Agents (administration & dosage), Antiparkinson agent, Bilateral, Chemotherapy, Combined Modality Therapy, Comparative study, Electric Stimulation Therapy, Electrical stimulus, Evolution, Female, Gait Disorders, Neurologic (drug therapy), Gait Disorders, Neurologic (etiology), Humans, Instrumentation therapy, Kinematics, Levodopa, Levodopa (administration & dosage), Male, Middle Aged, Motion analysis, Parkinson Disease (complications), Parkinson Disease (drug therapy), Parkinson disease, Subthalamic Nucleus (physiology), Subthalamic nucleus, Treatment Outcome, Walking.
- MESH :
- chemical , administration & dosage : Antiparkinson Agents, Levodopa.
- complications : Parkinson Disease.
- drug therapy : Gait Disorders, Neurologic, Parkinson Disease.
- etiology : Gait Disorders, Neurologic.
- physiology : Subthalamic Nucleus.
- Combined Modality Therapy, Electric Stimulation Therapy, Female, Humans, Male, Middle Aged, Treatment Outcome.
Abstract
Background: Stimulation of the subthalamic nucleus is proposed for the treatment of patients presenting with severe Parkinson disease. The effect on gait is not clearly established. Objectives: To evaluate objectively the influence of bilateral subthalamic nucleus stimulation on gait in Parkinson disease and to compare it with the effects of levodopa treatment. Methods: Ten patients underwent bilateral subthalamic nucleus stimulation. The preoperative and postoperative (3 months after surgery) clinical gait disturbances, as well as spatial and temporal gait parameters, were analyzed in off and on-drug conditions. The gait analysis was performed using a video motion analysis system (optoelectronic VICON system; Oxford Metrics, Oxford, England). Results: In the off condition, there was an improvement after surgery for the total motor score and the gait subscore. In the on-drug condition, there was an improvement in levodopa-induced dyskinesias and the motor score, whereas the gait subscore was unchanged. For the gait parameters measured by the video motion analysis system system, there was also an improvement in the off condition and to a lesser extent in the on-drug condition. Conclusions: Our method allowed exact quantification of the benefit of surgery on gait parameters. Compared with the levodopa treatment, the effect of stimulation on gait kinematic parameters seems to be qualitatively similar but quantitatively different with a lower benefit on gait velocity and stride length. Concerning the pathophysiology of gait troubles in Parkinson disease, the deficit in control of stride length would be the fundamental deficit. The study underlines the possible role of the subthalamic nucleus on the stride length regulation.
Affiliations:
- France
- Hauts-de-France, Nord-Pas-de-Calais
- Lille
- Université Lille 2, Université Lille Nord de France
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Le document en format XML
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wicri:level="3"><inist:fA14 i1="01"><s1>Department of Gait Analysis, Centre Hospitalier et Universitaire de Lille</s1><s2>Lille</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Hauts-de-France</region><region type="old region">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Department of Neurology, Centre Hospitalier et Universitaire de Lille</s1><s2>Lille</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Hauts-de-France</region><region type="old region">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Blatt, Jean Louis" sort="Blatt, Jean Louis" uniqKey="Blatt J" first="Jean-Louis" last="Blatt">Jean-Louis Blatt</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Gait Analysis, Centre Hospitalier et Universitaire de Lille</s1><s2>Lille</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Hauts-de-France</region><region type="old region">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Department of Clinical Neurophysiology, Centre Hospitalier et Universitaire de Lille</s1><s2>Lille</s2><s3>FRA</s3><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Hauts-de-France</region><region type="old region">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name 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type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Duhamel, Alain" sort="Duhamel, Alain" uniqKey="Duhamel A" first="Alain" last="Duhamel">Alain Duhamel</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Department of Biostatic, Centre Hospitalier et Universitaire de Lille</s1><s2>Lille</s2><s3>FRA</s3><sZ>4 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Hauts-de-France</region><region type="old region">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Perina, Miriam" sort="Perina, Miriam" uniqKey="Perina M" first="Miriam" last="Perina">Miriam Perina</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Department of Neurology, Centre Hospitalier et Universitaire de Lille</s1><s2>Lille</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><region 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type="region">Hauts-de-France</region><region type="old region">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Guieu, Jean Daniel" sort="Guieu, Jean Daniel" uniqKey="Guieu J" first="Jean-Daniel" last="Guieu">Jean-Daniel Guieu</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Gait Analysis, Centre Hospitalier et Universitaire de Lille</s1><s2>Lille</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Hauts-de-France</region><region type="old region">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Department of Clinical Neurophysiology, Centre Hospitalier et Universitaire de Lille</s1><s2>Lille</s2><s3>FRA</s3><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Hauts-de-France</region><region type="old region">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Destee, Alain" sort="Destee, Alain" uniqKey="Destee A" first="Alain" last="Destee">Alain Destée</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Gait Analysis, Centre Hospitalier et Universitaire de Lille</s1><s2>Lille</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Hauts-de-France</region><region type="old region">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName><placeName><settlement type="city">Lille</settlement><region type="region" nuts="2">Hauts-de-France</region><region type="old region" nuts="2">Nord-Pas-de-Calais</region></placeName><orgName type="university" n="3">Université Lille 2</orgName><orgName type="institution" wicri:auto="newGroup">Université Lille Nord de France</orgName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Department of Neurology, Centre Hospitalier et Universitaire de Lille</s1><s2>Lille</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Hauts-de-France</region><region type="old region">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName><placeName><settlement type="city">Lille</settlement><region type="region" nuts="2">Hauts-de-France</region><region type="old region" nuts="2">Nord-Pas-de-Calais</region></placeName><orgName type="university" n="3">Université Lille 2</orgName><orgName type="institution" wicri:auto="newGroup">Université Lille Nord de France</orgName></affiliation></author><author><name sortKey="Defebvre, Luc" sort="Defebvre, Luc" uniqKey="Defebvre L" first="Luc" last="Defebvre">Luc Defebvre</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Gait Analysis, Centre Hospitalier et Universitaire de Lille</s1><s2>Lille</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Hauts-de-France</region><region type="old region">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName><placeName><settlement type="city">Lille</settlement><region type="region" nuts="2">Hauts-de-France</region><region type="old region" nuts="2">Nord-Pas-de-Calais</region></placeName><orgName type="university" n="3">Université Lille 2</orgName><orgName type="institution" wicri:auto="newGroup">Université Lille Nord de France</orgName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Department of Neurology, Centre Hospitalier et Universitaire de Lille</s1><s2>Lille</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Hauts-de-France</region><region type="old region">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName><placeName><settlement type="city">Lille</settlement><region type="region" nuts="2">Hauts-de-France</region><region type="old region" nuts="2">Nord-Pas-de-Calais</region></placeName><orgName type="university" n="3">Université Lille 2</orgName><orgName type="institution" wicri:auto="newGroup">Université Lille Nord de France</orgName></affiliation></author></analytic><series><title level="j" type="main">Archives of neurology : (Chicago)</title><title level="j" type="abbreviated">Arch. neurol. : (Chic.)</title><idno type="ISSN">0003-9942</idno><imprint><date when="2003">2003</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Archives of neurology : (Chicago)</title><title level="j" type="abbreviated">Arch. neurol. : (Chic.)</title><idno type="ISSN">0003-9942</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Antiparkinson Agents (administration & dosage)</term><term>Antiparkinson agent</term><term>Bilateral</term><term>Chemotherapy</term><term>Combined Modality Therapy</term><term>Comparative study</term><term>Electric Stimulation Therapy</term><term>Electrical stimulus</term><term>Evolution</term><term>Female</term><term>Gait Disorders, Neurologic (drug therapy)</term><term>Gait Disorders, Neurologic (etiology)</term><term>Humans</term><term>Instrumentation therapy</term><term>Kinematics</term><term>Levodopa</term><term>Levodopa (administration & dosage)</term><term>Male</term><term>Middle Aged</term><term>Motion analysis</term><term>Parkinson Disease (complications)</term><term>Parkinson Disease (drug therapy)</term><term>Parkinson disease</term><term>Subthalamic Nucleus (physiology)</term><term>Subthalamic nucleus</term><term>Treatment Outcome</term><term>Walking</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Antiparkinson Agents</term><term>Levodopa</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Gait Disorders, Neurologic</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Gait Disorders, Neurologic</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Subthalamic Nucleus</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Combined Modality Therapy</term><term>Electric Stimulation Therapy</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Treatment Outcome</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Parkinson maladie</term><term>Stimulus électrique</term><term>Noyau sousthalamique</term><term>Bilatéral</term><term>Lévodopa</term><term>Chimiothérapie</term><term>Antiparkinsonien</term><term>Cinématique</term><term>Marche à pied</term><term>Analyse mouvement</term><term>Etude comparative</term><term>Traitement instrumental</term><term>Evolution</term><term>Adulte</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Adulte</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background: Stimulation of the subthalamic nucleus is proposed for the treatment of patients presenting with severe Parkinson disease. The effect on gait is not clearly established. Objectives: To evaluate objectively the influence of bilateral subthalamic nucleus stimulation on gait in Parkinson disease and to compare it with the effects of levodopa treatment. Methods: Ten patients underwent bilateral subthalamic nucleus stimulation. The preoperative and postoperative (3 months after surgery) clinical gait disturbances, as well as spatial and temporal gait parameters, were analyzed in off and on-drug conditions. The gait analysis was performed using a video motion analysis system (optoelectronic VICON system; Oxford Metrics, Oxford, England). Results: In the off condition, there was an improvement after surgery for the total motor score and the gait subscore. In the on-drug condition, there was an improvement in levodopa-induced dyskinesias and the motor score, whereas the gait subscore was unchanged. For the gait parameters measured by the video motion analysis system system, there was also an improvement in the off condition and to a lesser extent in the on-drug condition. Conclusions: Our method allowed exact quantification of the benefit of surgery on gait parameters. Compared with the levodopa treatment, the effect of stimulation on gait kinematic parameters seems to be qualitatively similar but quantitatively different with a lower benefit on gait velocity and stride length. Concerning the pathophysiology of gait troubles in Parkinson disease, the deficit in control of stride length would be the fundamental deficit. The study underlines the possible role of the subthalamic nucleus on the stride length regulation.</div></front></TEI><affiliations><list><country><li>France</li></country><region><li>Hauts-de-France</li><li>Nord-Pas-de-Calais</li></region><settlement><li>Lille</li></settlement><orgName><li>Université Lille 2</li><li>Université Lille Nord de France</li></orgName></list><tree><country name="France"><region name="Hauts-de-France"><name sortKey="Krystkowiak, Pierre" sort="Krystkowiak, Pierre" uniqKey="Krystkowiak P" first="Pierre" last="Krystkowiak">Pierre Krystkowiak</name></region><name sortKey="Blatt, Jean Louis" sort="Blatt, Jean Louis" uniqKey="Blatt J" first="Jean-Louis" last="Blatt">Jean-Louis Blatt</name><name sortKey="Blatt, Jean Louis" sort="Blatt, Jean Louis" uniqKey="Blatt J" first="Jean-Louis" last="Blatt">Jean-Louis Blatt</name><name sortKey="Blond, Serge" sort="Blond, Serge" uniqKey="Blond S" first="Serge" last="Blond">Serge Blond</name><name sortKey="Blond, Serge" sort="Blond, Serge" uniqKey="Blond S" first="Serge" last="Blond">Serge Blond</name><name sortKey="Bourriez, Jean Louis" sort="Bourriez, Jean Louis" uniqKey="Bourriez J" first="Jean-Louis" last="Bourriez">Jean-Louis Bourriez</name><name sortKey="Bourriez, Jean Louis" sort="Bourriez, Jean Louis" uniqKey="Bourriez J" first="Jean-Louis" last="Bourriez">Jean-Louis Bourriez</name><name sortKey="Defebvre, Luc" sort="Defebvre, Luc" uniqKey="Defebvre L" first="Luc" last="Defebvre">Luc Defebvre</name><name sortKey="Defebvre, Luc" sort="Defebvre, Luc" uniqKey="Defebvre L" first="Luc" last="Defebvre">Luc Defebvre</name><name sortKey="Destee, Alain" sort="Destee, Alain" uniqKey="Destee A" first="Alain" last="Destee">Alain Destée</name><name sortKey="Destee, Alain" sort="Destee, Alain" uniqKey="Destee A" first="Alain" last="Destee">Alain Destée</name><name sortKey="Duhamel, Alain" sort="Duhamel, Alain" uniqKey="Duhamel A" first="Alain" last="Duhamel">Alain Duhamel</name><name sortKey="Guieu, Jean Daniel" sort="Guieu, Jean Daniel" uniqKey="Guieu J" first="Jean-Daniel" last="Guieu">Jean-Daniel Guieu</name><name sortKey="Guieu, Jean Daniel" sort="Guieu, Jean Daniel" uniqKey="Guieu J" first="Jean-Daniel" last="Guieu">Jean-Daniel Guieu</name><name sortKey="Krystkowiak, Pierre" sort="Krystkowiak, Pierre" uniqKey="Krystkowiak P" first="Pierre" last="Krystkowiak">Pierre Krystkowiak</name><name sortKey="Perina, Miriam" sort="Perina, Miriam" uniqKey="Perina M" first="Miriam" last="Perina">Miriam Perina</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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