Bilateral subthalamic nucleus stimulation improves balance control in Parkinson's disease
Identifieur interne : 000526 ( Ncbi/Checkpoint ); précédent : 000525; suivant : 000527Bilateral subthalamic nucleus stimulation improves balance control in Parkinson's disease
Auteurs : S. Colnat-Coulbois ; G. Gauchard ; L. Maillard ; G. Barroche ; H. Vespignani ; J. Auque ; P. PerrinSource :
- Journal of Neurology, Neurosurgery, and Psychiatry [ 0022-3050 ] ; 2005.
English descriptors
- KwdEn :
- Aged, Basal Ganglia (pathology), Deep Brain Stimulation (instrumentation), Electrodes, Implanted, Electromyography (instrumentation), Female, Functional Laterality (physiology), Humans, Magnetic Resonance Imaging, Male, Middle Aged, Muscle Rigidity (etiology), Muscle Rigidity (prevention & control), Muscle, Skeletal (innervation), Nerve Degeneration (pathology), Neurosurgical Procedures, Parkinson Disease (complications), Parkinson Disease (pathology), Parkinson Disease (therapy), Postoperative Care, Postural Balance (physiology), Preoperative Care, Proprioception (physiology), Severity of Illness Index, Somatosensory Disorders (diagnosis), Somatosensory Disorders (etiology), Somatosensory Disorders (therapy), Subthalamic Nucleus (physiology), Subthalamic Nucleus (surgery).
- MESH :
- complications : Parkinson Disease.
- diagnosis : Somatosensory Disorders.
- etiology : Muscle Rigidity, Somatosensory Disorders.
- innervation : Muscle, Skeletal.
- instrumentation : Deep Brain Stimulation, Electromyography.
- pathology : Basal Ganglia, Nerve Degeneration, Parkinson Disease.
- physiology : Functional Laterality, Postural Balance, Proprioception, Subthalamic Nucleus.
- prevention & control : Muscle Rigidity.
- surgery : Subthalamic Nucleus.
- therapy : Parkinson Disease, Somatosensory Disorders.
- Aged, Electrodes, Implanted, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Neurosurgical Procedures, Postoperative Care, Preoperative Care, Severity of Illness Index.
Abstract
Url:
DOI: 10.1136/jnnp.2004.047829
PubMed: 15897498
PubMed Central: 1739669
Affiliations:
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PMC:1739669Le document en format XML
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Bilateral subthalamic nucleus stimulation improves balance control in Parkinson's disease</title>
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<series><title level="j">Journal of Neurology, Neurosurgery, and Psychiatry</title>
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<term>Basal Ganglia (pathology)</term>
<term>Deep Brain Stimulation (instrumentation)</term>
<term>Electrodes, Implanted</term>
<term>Electromyography (instrumentation)</term>
<term>Female</term>
<term>Functional Laterality (physiology)</term>
<term>Humans</term>
<term>Magnetic Resonance Imaging</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Muscle Rigidity (etiology)</term>
<term>Muscle Rigidity (prevention & control)</term>
<term>Muscle, Skeletal (innervation)</term>
<term>Nerve Degeneration (pathology)</term>
<term>Neurosurgical Procedures</term>
<term>Parkinson Disease (complications)</term>
<term>Parkinson Disease (pathology)</term>
<term>Parkinson Disease (therapy)</term>
<term>Postoperative Care</term>
<term>Postural Balance (physiology)</term>
<term>Preoperative Care</term>
<term>Proprioception (physiology)</term>
<term>Severity of Illness Index</term>
<term>Somatosensory Disorders (diagnosis)</term>
<term>Somatosensory Disorders (etiology)</term>
<term>Somatosensory Disorders (therapy)</term>
<term>Subthalamic Nucleus (physiology)</term>
<term>Subthalamic Nucleus (surgery)</term>
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<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Parkinson Disease</term>
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<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Somatosensory Disorders</term>
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<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Muscle Rigidity</term>
<term>Somatosensory Disorders</term>
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<keywords scheme="MESH" qualifier="innervation" xml:lang="en"><term>Muscle, Skeletal</term>
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<keywords scheme="MESH" qualifier="instrumentation" xml:lang="en"><term>Deep Brain Stimulation</term>
<term>Electromyography</term>
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<keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Basal Ganglia</term>
<term>Nerve Degeneration</term>
<term>Parkinson Disease</term>
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<keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Functional Laterality</term>
<term>Postural Balance</term>
<term>Proprioception</term>
<term>Subthalamic Nucleus</term>
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<keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Muscle Rigidity</term>
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<keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Subthalamic Nucleus</term>
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<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Parkinson Disease</term>
<term>Somatosensory Disorders</term>
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<term>Electrodes, Implanted</term>
<term>Female</term>
<term>Humans</term>
<term>Magnetic Resonance Imaging</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Neurosurgical Procedures</term>
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<front><div type="abstract" xml:lang="en"><p><bold>Background:</bold>
Parkinson's disease (PD), the most common basal ganglia degenerative disease, affects balance control, especially when patients change balance strategy during postural tasks. Bilateral chronic stimulation of the subthalamic nucleus (STN) is therapeutically useful in advanced PD, and reduces the motor signs of patients. Nevertheless, the effects of STN stimulation on postural control are still debatable. </p>
<p><bold>Aims:</bold>
To assess the impact of bilateral STN stimulation on balance control in PD and to determine how basal ganglia related sensorimotor modifications act on neurosensorial organisation of balance and motor postural programming. </p>
<p><bold>Methods:</bold>
Twelve subjects aged 45–70 years underwent unified Parkinson's disease rating scale motor (part III) clinical tests, static and dynamic posturography, including sensory organisation and adaptation tests, shortly before and six months after bilateral implantation of electrodes into the STN. </p>
<p><bold>Results:</bold>
The postoperative static test showed an improvement in postural control precision both in eyes open and eyes closed conditions. The dynamic test highlighted the decreased number of falls and the ability of the patients to develop more appropriate sensorimotor strategies when stimulated. The sensory organisation test showed an improvement of equilibrium score and, thus, a better resolution of sensorial conflicts. </p>
<p><bold>Conclusions:</bold>
STN stimulation allowed a reduction in rigidity and therefore an improvement in the ability to use muscular proprioception as reliable information, resulting in vestibulo-proprioceptive conflict suppression. STN stimulation has a synergistic effect with levodopa for postural control. Accordingly, non-dopaminergic pathways could be involved in postural regulation and STN stimulation may influence the functioning of these pathways. </p>
</div>
</front>
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<affiliations><list></list>
<tree><noCountry><name sortKey="Auque, J" sort="Auque, J" uniqKey="Auque J" first="J" last="Auque">J. Auque</name>
<name sortKey="Barroche, G" sort="Barroche, G" uniqKey="Barroche G" first="G" last="Barroche">G. Barroche</name>
<name sortKey="Colnat Coulbois, S" sort="Colnat Coulbois, S" uniqKey="Colnat Coulbois S" first="S" last="Colnat-Coulbois">S. Colnat-Coulbois</name>
<name sortKey="Gauchard, G" sort="Gauchard, G" uniqKey="Gauchard G" first="G" last="Gauchard">G. Gauchard</name>
<name sortKey="Maillard, L" sort="Maillard, L" uniqKey="Maillard L" first="L" last="Maillard">L. Maillard</name>
<name sortKey="Perrin, P" sort="Perrin, P" uniqKey="Perrin P" first="P." last="Perrin">P. Perrin</name>
<name sortKey="Vespignani, H" sort="Vespignani, H" uniqKey="Vespignani H" first="H" last="Vespignani">H. Vespignani</name>
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