Gait and balance disorders in Parkinson's disease: Impaired active braking of the fall of centre of gravity
Identifieur interne : 000084 ( France/Analysis ); précédent : 000083; suivant : 000085Gait and balance disorders in Parkinson's disease: Impaired active braking of the fall of centre of gravity
Auteurs : Nathalie Chastan [France] ; Manh Cuong Do [France] ; Fabrice Bonneville [France] ; Frédéric Torny [France] ; Frédéric Bloch [France] ; G. W. Max Westby [France] ; Didier Dormont [France] ; Yves Agid [France] ; Marie-Laure Welter [France]Source :
- Movement Disorders [ 0885-3185 ] ; 2009-01-30.
English descriptors
Abstract
Gait and balance disorders are common in Parkinson's disease (PD), but its pathophysiology is still poorly understood. Step length, antero‐posterior, and vertical velocities of the center of gravity (CG) during gait initiation were analyzed in 32 controls and 32 PD patients, with and without levodopa, using a force platform. Brain volumes and mesencephalic surface area were measured in PD patients. During the swing limb period, controls showed a fall in the CG, which was reversed before foot‐contact indicating active braking of the CG fall. In PD patients, without levodopa, step length and velocity were significantly reduced and no braking occurred before foot‐contact in 22 patients. With levodopa, step length and velocity increased in all patients and 7 patients improved their braking capacity. PD patients with normal braking (n = 17) had significantly lower gait and balance disorder scores and higher normalized‐mesencephalic surface areas compared to patients with impaired braking (n = 15). The decreased step length and velocity, characteristic of PD, mainly result from degeneration of central dopaminergic systems. The markedly decreased braking capacity observed in half the PD patients contributes to their gait disorders and postural instability, perhaps as a result of nondopaminergic lesions, possibly at the mesencephalic level. © 2008 Movement Disorder Society
Url:
DOI: 10.1002/mds.22269
Affiliations:
- France
- Île-de-France
- Orsay, Paris, Rouen
- Hôpital de la Salpêtrière, Université Paris-Sud, Université Pierre-et-Marie-Curie
Links toward previous steps (curation, corpus...)
- to stream Main, to step Corpus: 001600
- to stream Main, to step Curation: 001367
- to stream Main, to step Exploration: 000A79
- to stream France, to step Extraction: 000084
Links to Exploration step
ISTEX:0ED61862F7ABEEF5D1BF780D12CC96A8747C1EFELe document en format XML
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Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2009-01-30">2009-01-30</date><biblScope unit="volume">24</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="188">188</biblScope><biblScope unit="page" to="195">195</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">0ED61862F7ABEEF5D1BF780D12CC96A8747C1EFE</idno><idno type="DOI">10.1002/mds.22269</idno><idno type="ArticleID">MDS22269</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Parkinson's disease</term><term>gait initiation</term><term>magnetic resonance imaging</term><term>postural instability</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Gait and balance disorders are common in Parkinson's disease (PD), but its pathophysiology is still poorly understood. Step length, antero‐posterior, and vertical velocities of the center of gravity (CG) during gait initiation were analyzed in 32 controls and 32 PD patients, with and without levodopa, using a force platform. Brain volumes and mesencephalic surface area were measured in PD patients. During the swing limb period, controls showed a fall in the CG, which was reversed before foot‐contact indicating active braking of the CG fall. In PD patients, without levodopa, step length and velocity were significantly reduced and no braking occurred before foot‐contact in 22 patients. With levodopa, step length and velocity increased in all patients and 7 patients improved their braking capacity. PD patients with normal braking (n = 17) had significantly lower gait and balance disorder scores and higher normalized‐mesencephalic surface areas compared to patients with impaired braking (n = 15). The decreased step length and velocity, characteristic of PD, mainly result from degeneration of central dopaminergic systems. The markedly decreased braking capacity observed in half the PD patients contributes to their gait disorders and postural instability, perhaps as a result of nondopaminergic lesions, possibly at the mesencephalic level. © 2008 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>France</li></country><region><li>Île-de-France</li></region><settlement><li>Orsay</li><li>Paris</li><li>Rouen</li></settlement><orgName><li>Hôpital de la Salpêtrière</li><li>Université Paris-Sud</li><li>Université Pierre-et-Marie-Curie</li></orgName></list><tree><country name="France"><noRegion><name sortKey="Chastan, Nathalie" sort="Chastan, Nathalie" uniqKey="Chastan N" first="Nathalie" last="Chastan">Nathalie Chastan</name></noRegion><name sortKey="Agid, Yves" sort="Agid, Yves" uniqKey="Agid Y" first="Yves" last="Agid">Yves Agid</name><name sortKey="Agid, Yves" sort="Agid, Yves" uniqKey="Agid Y" first="Yves" last="Agid">Yves Agid</name><name sortKey="Agid, Yves" sort="Agid, Yves" uniqKey="Agid Y" first="Yves" last="Agid">Yves Agid</name><name sortKey="Bloch, Frederic" sort="Bloch, Frederic" uniqKey="Bloch F" first="Frédéric" last="Bloch">Frédéric Bloch</name><name sortKey="Bloch, Frederic" sort="Bloch, Frederic" uniqKey="Bloch F" first="Frédéric" last="Bloch">Frédéric Bloch</name><name sortKey="Bloch, Frederic" sort="Bloch, Frederic" uniqKey="Bloch F" first="Frédéric" last="Bloch">Frédéric Bloch</name><name sortKey="Bonneville, Fabrice" sort="Bonneville, Fabrice" uniqKey="Bonneville F" first="Fabrice" last="Bonneville">Fabrice Bonneville</name><name sortKey="Bonneville, Fabrice" sort="Bonneville, Fabrice" uniqKey="Bonneville F" first="Fabrice" last="Bonneville">Fabrice Bonneville</name><name sortKey="Bonneville, Fabrice" sort="Bonneville, Fabrice" uniqKey="Bonneville F" first="Fabrice" last="Bonneville">Fabrice Bonneville</name><name sortKey="Chastan, Nathalie" sort="Chastan, Nathalie" uniqKey="Chastan N" first="Nathalie" last="Chastan">Nathalie Chastan</name><name sortKey="Chastan, Nathalie" sort="Chastan, Nathalie" uniqKey="Chastan N" first="Nathalie" last="Chastan">Nathalie Chastan</name><name sortKey="Chastan, Nathalie" sort="Chastan, Nathalie" uniqKey="Chastan N" first="Nathalie" last="Chastan">Nathalie Chastan</name><name sortKey="Do, Manh Cuong" sort="Do, Manh Cuong" uniqKey="Do M" first="Manh Cuong" last="Do">Manh Cuong Do</name><name sortKey="Do, Manh Cuong" sort="Do, Manh Cuong" uniqKey="Do M" first="Manh Cuong" last="Do">Manh Cuong Do</name><name sortKey="Dormont, Didier" sort="Dormont, Didier" uniqKey="Dormont D" first="Didier" last="Dormont">Didier Dormont</name><name sortKey="Dormont, Didier" sort="Dormont, Didier" uniqKey="Dormont D" first="Didier" last="Dormont">Didier Dormont</name><name sortKey="Dormont, Didier" sort="Dormont, Didier" uniqKey="Dormont D" first="Didier" last="Dormont">Didier Dormont</name><name sortKey="Torny, Frederic" sort="Torny, Frederic" uniqKey="Torny F" first="Frédéric" last="Torny">Frédéric Torny</name><name sortKey="Torny, Frederic" sort="Torny, Frederic" uniqKey="Torny F" first="Frédéric" last="Torny">Frédéric Torny</name><name sortKey="Torny, Frederic" sort="Torny, Frederic" uniqKey="Torny F" first="Frédéric" last="Torny">Frédéric Torny</name><name sortKey="Welter, Marie Aure" sort="Welter, Marie Aure" uniqKey="Welter M" first="Marie-Laure" last="Welter">Marie-Laure Welter</name><name sortKey="Welter, Marie Aure" sort="Welter, Marie Aure" uniqKey="Welter M" first="Marie-Laure" last="Welter">Marie-Laure Welter</name><name sortKey="Welter, Marie Aure" sort="Welter, Marie Aure" uniqKey="Welter M" first="Marie-Laure" last="Welter">Marie-Laure Welter</name><name sortKey="Welter, Marie Aure" sort="Welter, Marie Aure" uniqKey="Welter M" first="Marie-Laure" last="Welter">Marie-Laure Welter</name><name sortKey="Westby, G W Max" sort="Westby, G W Max" uniqKey="Westby G" first="G. 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