Normal and pathological gait: what we learn from Parkinson's disease.
Identifieur interne : 000789 ( PubMed/Curation ); précédent : 000788; suivant : 000790Normal and pathological gait: what we learn from Parkinson's disease.
Auteurs : David Grabli [France] ; Carine Karachi ; Marie-Laure Welter ; Brian Lau ; Etienne C. Hirsch ; Marie Vidailhet ; Chantal FrançoisSource :
- Journal of neurology, neurosurgery, and psychiatry [ 1468-330X ] ; 2012.
English descriptors
- KwdEn :
- Accidental Falls, Brain Stem (metabolism), Brain Stem (physiopathology), Cerebellum (metabolism), Cerebellum (physiopathology), Cerebral Cortex (metabolism), Cerebral Cortex (physiopathology), Controlled Clinical Trials as Topic, Deep Brain Stimulation, Dopamine (metabolism), Epinephrine (metabolism), Gait (physiology), Gait Disorders, Neurologic (etiology), Gait Disorders, Neurologic (metabolism), Gait Disorders, Neurologic (physiopathology), Gait Disorders, Neurologic (therapy), Humans, Parkinson Disease (complications), Parkinson Disease (metabolism), Parkinson Disease (physiopathology), Parkinson Disease (therapy), Postural Balance, Serotonin (metabolism).
- MESH :
- chemical , metabolism : Dopamine, Epinephrine, Serotonin.
- complications : Parkinson Disease.
- etiology : Gait Disorders, Neurologic.
- metabolism : Brain Stem, Cerebellum, Cerebral Cortex, Gait Disorders, Neurologic, Parkinson Disease.
- physiology : Gait.
- physiopathology : Brain Stem, Cerebellum, Cerebral Cortex, Gait Disorders, Neurologic, Parkinson Disease.
- therapy : Gait Disorders, Neurologic, Parkinson Disease.
- Accidental Falls, Controlled Clinical Trials as Topic, Deep Brain Stimulation, Humans, Postural Balance.
Abstract
Gait and balance disorders represent a major therapeutic challenge in Parkinson's disease (PD). These symptoms respond poorly to dopaminergic treatments, except in the early phase of the disease. Currently, no other treatment is particularly efficient and rehabilitation appears to be the most effective approach. Since these gait and balance deficits are resistant to dopaminergic drugs, their occurrence could be related to the development of extradopaminergic lesions in PD patients. We provide a comprehensive description of the clinical features of gait and balance disorders in PD. We also highlight the brain networks involved in gait and balance control in animals and humans with a particular focus on the relevant structures in the context of PD, such as the mesencephalic locomotor region. We also review other neuronal systems that may be involved in the physiopathology of gait and balance disorders in PD (noradrenergic and serotoninergic systems, cerebellum and cortex). In addition, we review recent evidence regarding functional neurosurgery for gait disorders in PD and propose new directions for future therapeutic research.
DOI: 10.1136/jnnp-2012-302263
PubMed: 22752693
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pubmed:22752693Le document en format XML
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<term>Cerebellum (metabolism)</term>
<term>Cerebellum (physiopathology)</term>
<term>Cerebral Cortex (metabolism)</term>
<term>Cerebral Cortex (physiopathology)</term>
<term>Controlled Clinical Trials as Topic</term>
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<term>Gait Disorders, Neurologic (metabolism)</term>
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<term>Gait Disorders, Neurologic (therapy)</term>
<term>Humans</term>
<term>Parkinson Disease (complications)</term>
<term>Parkinson Disease (metabolism)</term>
<term>Parkinson Disease (physiopathology)</term>
<term>Parkinson Disease (therapy)</term>
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<term>Serotonin (metabolism)</term>
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<front><div type="abstract" xml:lang="en">Gait and balance disorders represent a major therapeutic challenge in Parkinson's disease (PD). These symptoms respond poorly to dopaminergic treatments, except in the early phase of the disease. Currently, no other treatment is particularly efficient and rehabilitation appears to be the most effective approach. Since these gait and balance deficits are resistant to dopaminergic drugs, their occurrence could be related to the development of extradopaminergic lesions in PD patients. We provide a comprehensive description of the clinical features of gait and balance disorders in PD. We also highlight the brain networks involved in gait and balance control in animals and humans with a particular focus on the relevant structures in the context of PD, such as the mesencephalic locomotor region. We also review other neuronal systems that may be involved in the physiopathology of gait and balance disorders in PD (noradrenergic and serotoninergic systems, cerebellum and cortex). In addition, we review recent evidence regarding functional neurosurgery for gait disorders in PD and propose new directions for future therapeutic research.</div>
</front>
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