Normal and pathological gait: what we learn from Parkinson's disease
Identifieur interne : 000005 ( France/Analysis ); précédent : 000004; suivant : 000006Normal and pathological gait: what we learn from Parkinson's disease
Auteurs : David Grabli [France] ; Carine Karachi [France] ; Marie-Laure Welter [France] ; Brian Lau [France, États-Unis] ; Etienne C. Hirsch [France] ; Marie Vidailhet [France] ; Chantal François [France]Source :
- Journal of Neurology, Neurosurgery & Psychiatry [ 0022-3050 ] ; 2012-10.
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.
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DOI: 10.1136/jnnp-2012-302263
Affiliations:
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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></TEI><affiliations><list><country><li>France</li><li>États-Unis</li></country><region><li>État de New York</li></region><settlement><li>New York</li><li>Paris</li></settlement><orgName><li>Université Columbia</li></orgName></list><tree><country name="France"><noRegion><name sortKey="Grabli, David" sort="Grabli, David" uniqKey="Grabli D" first="David" last="Grabli">David Grabli</name></noRegion><name sortKey="Francois, Chantal" sort="Francois, Chantal" uniqKey="Francois C" first="Chantal" last="François">Chantal François</name><name sortKey="Francois, Chantal" sort="Francois, Chantal" uniqKey="Francois C" first="Chantal" last="François">Chantal François</name><name sortKey="Francois, Chantal" sort="Francois, Chantal" uniqKey="Francois C" first="Chantal" last="François">Chantal François</name><name sortKey="Grabli, David" sort="Grabli, David" uniqKey="Grabli D" first="David" last="Grabli">David Grabli</name><name sortKey="Grabli, David" sort="Grabli, David" uniqKey="Grabli D" first="David" last="Grabli">David Grabli</name><name sortKey="Grabli, David" sort="Grabli, David" uniqKey="Grabli D" first="David" last="Grabli">David Grabli</name><name sortKey="Hirsch, Etienne C" sort="Hirsch, Etienne C" uniqKey="Hirsch E" first="Etienne C" last="Hirsch">Etienne C. Hirsch</name><name sortKey="Hirsch, Etienne C" sort="Hirsch, Etienne C" uniqKey="Hirsch E" first="Etienne C" last="Hirsch">Etienne C. Hirsch</name><name sortKey="Hirsch, Etienne C" sort="Hirsch, Etienne C" uniqKey="Hirsch E" first="Etienne C" last="Hirsch">Etienne C. 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