Chronic bilateral pallidal stimulation and levodopa do not improve gait in the same way in Parkinson's disease : a study using a video motion analysis system
Identifieur interne : 001086 ( PascalFrancis/Checkpoint ); précédent : 001085; suivant : 001087Chronic bilateral pallidal stimulation and levodopa do not improve gait in the same way in Parkinson's disease : a study using a video motion analysis system
Auteurs : Pierre Krystkowiak [France] ; Jean Louis Blatt [France] ; Jean Louis Bourriez [France] ; Alain Duhamel [France] ; Myriam Perina [France] ; Gilles Kemoun [France] ; Serge Blond [France] ; Jean Daniel Guieu [France] ; Alain Destée [France] ; Luc Defebvre [France]Source :
- Journal of neurology [ 0340-5354 ] ; 2001.
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Abstract
Chronic bilateral internal globus pallidus (GPi) stimulation allows control of levodopa induced dyskinesias (LID) and motor symptoms in severe Parkinson's disease (PD). The effect on gait has not been clearly established. Different results have been reported, mostly consisting of clinical data. The aim of this study was to evaluate, by means of a video motion analysis system (optoelectronic VICON system), the influence of bilateral GPi stimulation on gait in PD. Five patients underwent bilateral GPi stimulation. The preoperative and postoperative (3 months after surgery) clinical gait disturbances (items 29 and 30 of the motor UPDRS), as well as spatial and temporal gait measurements (namely cadence, velocity, stride and step times, single and double limb support times, stride and step lengths) were analysed in off condition (the patient had received no treatment for 12 hours or merely the lowest dose of levodopa allowing him to walk for the gait analysis) and in the on drug condition (after administration of 200 mg of levodopa). The gait analysis was performed with the VICON system. In off condition, there was a statistically significant improvement after surgery for UPDRS III and gait (clinically assessed). In on drug condition, there was a significant improvement for LID whereas UPDRS III and clinical assessment of gait were unchanged. The VICON system also showed that surgery improved gait especially in off condition, but also in on drug condition. Our method allowed exact quantification of the influence of surgery on gait characteristics. As compared with levodopa treatment, the effect of stimulation seems to be different. Indeed, the results suggest only limited effects of pallidal stimulation on the control of stride length and rather point to compensatory additional mechanisms.
Affiliations:
- France
- Hauts-de-France, Nord-Pas-de-Calais
- Lille
- Université Lille 2, Université Lille Nord de France
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<author><name sortKey="Blond, Serge" sort="Blond, Serge" uniqKey="Blond S" first="Serge" last="Blond">Serge Blond</name>
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<s2>59037 Lille</s2>
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<s3>FRA</s3>
<sZ>7 aut.</sZ>
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<author><name sortKey="Guieu, Jean Daniel" sort="Guieu, Jean Daniel" uniqKey="Guieu J" first="Jean Daniel" last="Guieu">Jean Daniel Guieu</name>
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<settlement type="city">Lille</settlement>
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<s3>FRA</s3>
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<sZ>3 aut.</sZ>
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<placeName><settlement type="city">Lille</settlement>
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<orgName type="university" n="3">Université Lille 2</orgName>
<orgName type="institution" wicri:auto="newGroup">Université Lille Nord de France</orgName>
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<affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Department of Gait Analysis, Hôpital R. Salengro, CHRU</s1>
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<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>Neurologie A, Hôpital R. Salengro, CHRU</s1>
<s2>59037 Lille</s2>
<s3>FRA</s3>
<sZ>1 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
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<country>France</country>
<placeName><region type="region" nuts="2">Hauts-de-France</region>
<region type="old region" nuts="2">Nord-Pas-de-Calais</region>
<settlement type="city">Lille</settlement>
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<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 Gait Analysis, Hôpital R. Salengro, CHRU</s1>
<s2>59037 Lille</s2>
<s3>FRA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
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<placeName><region type="region" nuts="2">Hauts-de-France</region>
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<placeName><settlement type="city">Lille</settlement>
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<orgName type="institution" wicri:auto="newGroup">Université Lille Nord de France</orgName>
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</analytic>
<series><title level="j" type="main">Journal of neurology</title>
<title level="j" type="abbreviated">J. neurol.</title>
<idno type="ISSN">0340-5354</idno>
<imprint><date when="2001">2001</date>
</imprint>
</series>
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<seriesStmt><title level="j" type="main">Journal of neurology</title>
<title level="j" type="abbreviated">J. neurol.</title>
<idno type="ISSN">0340-5354</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antiparkinson agent</term>
<term>Bilateral</term>
<term>Chemotherapy</term>
<term>Chronic</term>
<term>Comparative study</term>
<term>Evolution</term>
<term>Gait disorder</term>
<term>Human</term>
<term>Instrumental stimulation</term>
<term>Levodopa</term>
<term>Pallidum</term>
<term>Parkinson disease</term>
<term>Treatment</term>
<term>Video recording</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Parkinson maladie</term>
<term>Trouble marche</term>
<term>Stimulation instrumentale</term>
<term>Bilatéral</term>
<term>Chronique</term>
<term>Pallidum</term>
<term>Lévodopa</term>
<term>Antiparkinsonien</term>
<term>Chimiothérapie</term>
<term>Traitement</term>
<term>Evolution</term>
<term>Homme</term>
<term>Etude comparative</term>
<term>Enregistrement vidéo</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term>
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<front><div type="abstract" xml:lang="en">Chronic bilateral internal globus pallidus (GPi) stimulation allows control of levodopa induced dyskinesias (LID) and motor symptoms in severe Parkinson's disease (PD). The effect on gait has not been clearly established. Different results have been reported, mostly consisting of clinical data. The aim of this study was to evaluate, by means of a video motion analysis system (optoelectronic VICON system), the influence of bilateral GPi stimulation on gait in PD. Five patients underwent bilateral GPi stimulation. The preoperative and postoperative (3 months after surgery) clinical gait disturbances (items 29 and 30 of the motor UPDRS), as well as spatial and temporal gait measurements (namely cadence, velocity, stride and step times, single and double limb support times, stride and step lengths) were analysed in off condition (the patient had received no treatment for 12 hours or merely the lowest dose of levodopa allowing him to walk for the gait analysis) and in the on drug condition (after administration of 200 mg of levodopa). The gait analysis was performed with the VICON system. In off condition, there was a statistically significant improvement after surgery for UPDRS III and gait (clinically assessed). In on drug condition, there was a significant improvement for LID whereas UPDRS III and clinical assessment of gait were unchanged. The VICON system also showed that surgery improved gait especially in off condition, but also in on drug condition. Our method allowed exact quantification of the influence of surgery on gait characteristics. As compared with levodopa treatment, the effect of stimulation seems to be different. Indeed, the results suggest only limited effects of pallidal stimulation on the control of stride length and rather point to compensatory additional mechanisms.</div>
</front>
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<fA03 i2="1"><s0>J. neurol.</s0>
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<fA05><s2>248</s2>
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<fA06><s2>11</s2>
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<fA08 i1="01" i2="1" l="ENG"><s1>Chronic bilateral pallidal stimulation and levodopa do not improve gait in the same way in Parkinson's disease : a study using a video motion analysis system</s1>
</fA08>
<fA11 i1="01" i2="1"><s1>KRYSTKOWIAK (Pierre)</s1>
</fA11>
<fA11 i1="02" i2="1"><s1>BLATT (Jean Louis)</s1>
</fA11>
<fA11 i1="03" i2="1"><s1>BOURRIEZ (Jean Louis)</s1>
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<fA11 i1="04" i2="1"><s1>DUHAMEL (Alain)</s1>
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<fA11 i1="05" i2="1"><s1>PERINA (Myriam)</s1>
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<fA11 i1="06" i2="1"><s1>KEMOUN (Gilles)</s1>
</fA11>
<fA11 i1="07" i2="1"><s1>BLOND (Serge)</s1>
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<fA11 i1="08" i2="1"><s1>GUIEU (Jean Daniel)</s1>
</fA11>
<fA11 i1="09" i2="1"><s1>DESTEE (Alain)</s1>
</fA11>
<fA11 i1="10" i2="1"><s1>DEFEBVRE (Luc)</s1>
</fA11>
<fA14 i1="01"><s1>Neurologie A, Hôpital R. Salengro, CHRU</s1>
<s2>59037 Lille</s2>
<s3>FRA</s3>
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<sZ>5 aut.</sZ>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
</fA14>
<fA14 i1="02"><s1>Department of Gait Analysis, Hôpital R. Salengro, CHRU</s1>
<s2>59037 Lille</s2>
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<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>3 aut.</sZ>
<sZ>6 aut.</sZ>
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<sZ>8 aut.</sZ>
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</fA14>
<fA14 i1="03"><s1>Department of Clinical Neurophysiology, Hôpital R. Salengro, CHRU</s1>
<s2>59037 Lille</s2>
<s3>FRA</s3>
<sZ>2 aut.</sZ>
<sZ>3 aut.</sZ>
<sZ>8 aut.</sZ>
</fA14>
<fA14 i1="04"><s1>Department of Biostatics, Hôpital R. Salengro, CHRU</s1>
<s2>59037 Lille</s2>
<s3>FRA</s3>
<sZ>4 aut.</sZ>
</fA14>
<fA14 i1="05"><s1>Department of Neurosurgery, Hôpital R. Salengro, CHRU</s1>
<s2>59037 Lille</s2>
<s3>FRA</s3>
<sZ>7 aut.</sZ>
</fA14>
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<fA60><s1>P</s1>
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<fA61><s0>A</s0>
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<fA64 i1="01" i2="1"><s0>Journal of neurology</s0>
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</fA66>
<fC01 i1="01" l="ENG"><s0>Chronic bilateral internal globus pallidus (GPi) stimulation allows control of levodopa induced dyskinesias (LID) and motor symptoms in severe Parkinson's disease (PD). The effect on gait has not been clearly established. Different results have been reported, mostly consisting of clinical data. The aim of this study was to evaluate, by means of a video motion analysis system (optoelectronic VICON system), the influence of bilateral GPi stimulation on gait in PD. Five patients underwent bilateral GPi stimulation. The preoperative and postoperative (3 months after surgery) clinical gait disturbances (items 29 and 30 of the motor UPDRS), as well as spatial and temporal gait measurements (namely cadence, velocity, stride and step times, single and double limb support times, stride and step lengths) were analysed in off condition (the patient had received no treatment for 12 hours or merely the lowest dose of levodopa allowing him to walk for the gait analysis) and in the on drug condition (after administration of 200 mg of levodopa). The gait analysis was performed with the VICON system. In off condition, there was a statistically significant improvement after surgery for UPDRS III and gait (clinically assessed). In on drug condition, there was a significant improvement for LID whereas UPDRS III and clinical assessment of gait were unchanged. The VICON system also showed that surgery improved gait especially in off condition, but also in on drug condition. Our method allowed exact quantification of the influence of surgery on gait characteristics. As compared with levodopa treatment, the effect of stimulation seems to be different. Indeed, the results suggest only limited effects of pallidal stimulation on the control of stride length and rather point to compensatory additional mechanisms.</s0>
</fC01>
<fC02 i1="01" i2="X"><s0>002B17G</s0>
</fC02>
<fC03 i1="01" i2="X" l="FRE"><s0>Parkinson maladie</s0>
<s5>01</s5>
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<fC03 i1="01" i2="X" l="ENG"><s0>Parkinson disease</s0>
<s5>01</s5>
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<fC03 i1="01" i2="X" l="SPA"><s0>Parkinson enfermedad</s0>
<s5>01</s5>
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<s5>04</s5>
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<fC03 i1="02" i2="X" l="ENG"><s0>Gait disorder</s0>
<s5>04</s5>
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<fC03 i1="02" i2="X" l="SPA"><s0>Trastorno marcha</s0>
<s5>04</s5>
</fC03>
<fC03 i1="03" i2="X" l="FRE"><s0>Stimulation instrumentale</s0>
<s5>07</s5>
</fC03>
<fC03 i1="03" i2="X" l="ENG"><s0>Instrumental stimulation</s0>
<s5>07</s5>
</fC03>
<fC03 i1="03" i2="X" l="SPA"><s0>Estimulación instrumental</s0>
<s5>07</s5>
</fC03>
<fC03 i1="04" i2="X" l="FRE"><s0>Bilatéral</s0>
<s5>08</s5>
</fC03>
<fC03 i1="04" i2="X" l="ENG"><s0>Bilateral</s0>
<s5>08</s5>
</fC03>
<fC03 i1="04" i2="X" l="SPA"><s0>Bilateral</s0>
<s5>08</s5>
</fC03>
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<fC03 i1="05" i2="X" l="ENG"><s0>Chronic</s0>
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<fC03 i1="07" i2="X" l="SPA"><s0>Levodopa</s0>
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<s2>FR</s2>
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<s5>16</s5>
</fC03>
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<s5>16</s5>
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<fC03 i1="11" i2="X" l="FRE"><s0>Evolution</s0>
<s5>18</s5>
</fC03>
<fC03 i1="11" i2="X" l="ENG"><s0>Evolution</s0>
<s5>18</s5>
</fC03>
<fC03 i1="11" i2="X" l="SPA"><s0>Evolución</s0>
<s5>18</s5>
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<fC03 i1="12" i2="X" l="FRE"><s0>Homme</s0>
<s5>20</s5>
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<s5>20</s5>
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<s5>24</s5>
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<fC03 i1="14" i2="X" l="ENG"><s0>Video recording</s0>
<s5>24</s5>
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<fC03 i1="14" i2="X" l="SPA"><s0>Registro vídeo</s0>
<s5>24</s5>
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<s5>37</s5>
</fC07>
<fC07 i1="02" i2="X" l="FRE"><s0>Système nerveux central pathologie</s0>
<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="ENG"><s0>Central nervous system disease</s0>
<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="SPA"><s0>Sistema nervosio central patología</s0>
<s5>38</s5>
</fC07>
<fC07 i1="03" i2="X" l="FRE"><s0>Encéphale pathologie</s0>
<s5>39</s5>
</fC07>
<fC07 i1="03" i2="X" l="ENG"><s0>Cerebral disorder</s0>
<s5>39</s5>
</fC07>
<fC07 i1="03" i2="X" l="SPA"><s0>Encéfalo patología</s0>
<s5>39</s5>
</fC07>
<fC07 i1="04" i2="X" l="FRE"><s0>Extrapyramidal syndrome</s0>
<s5>40</s5>
</fC07>
<fC07 i1="04" i2="X" l="ENG"><s0>Extrapyramidal syndrome</s0>
<s5>40</s5>
</fC07>
<fC07 i1="04" i2="X" l="SPA"><s0>Extrapiramidal síndrome</s0>
<s5>40</s5>
</fC07>
<fC07 i1="05" i2="X" l="FRE"><s0>Maladie dégénérative</s0>
<s5>41</s5>
</fC07>
<fC07 i1="05" i2="X" l="ENG"><s0>Degenerative disease</s0>
<s5>41</s5>
</fC07>
<fC07 i1="05" i2="X" l="SPA"><s0>Enfermedad degenerativa</s0>
<s5>41</s5>
</fC07>
<fC07 i1="06" i2="X" l="FRE"><s0>Traitement instrumental</s0>
<s5>53</s5>
</fC07>
<fC07 i1="06" i2="X" l="ENG"><s0>Instrumentation therapy</s0>
<s5>53</s5>
</fC07>
<fC07 i1="06" i2="X" l="SPA"><s0>Tratamiento instrumental</s0>
<s5>53</s5>
</fC07>
<fC07 i1="07" i2="X" l="FRE"><s0>Encéphale</s0>
<s5>61</s5>
</fC07>
<fC07 i1="07" i2="X" l="ENG"><s0>Brain (vertebrata)</s0>
<s5>61</s5>
</fC07>
<fC07 i1="07" i2="X" l="SPA"><s0>Encéfalo</s0>
<s5>61</s5>
</fC07>
<fN21><s1>037</s1>
</fN21>
</pA>
</standard>
</inist>
<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="Kemoun, Gilles" sort="Kemoun, Gilles" uniqKey="Kemoun G" first="Gilles" last="Kemoun">Gilles Kemoun</name>
<name sortKey="Krystkowiak, Pierre" sort="Krystkowiak, Pierre" uniqKey="Krystkowiak P" first="Pierre" last="Krystkowiak">Pierre Krystkowiak</name>
<name sortKey="Perina, Myriam" sort="Perina, Myriam" uniqKey="Perina M" first="Myriam" last="Perina">Myriam Perina</name>
</country>
</tree>
</affiliations>
</record>
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