The Neuromodulatory Impact of Subthalamic Nucleus Deep Brain Stimulation on Gait and Postural Instability in Parkinson's Disease Patients: A Prospective Case Controlled Study.
Identifieur interne : 000310 ( Main/Curation ); précédent : 000309; suivant : 000311The Neuromodulatory Impact of Subthalamic Nucleus Deep Brain Stimulation on Gait and Postural Instability in Parkinson's Disease Patients: A Prospective Case Controlled Study.
Auteurs : Stanislaw Szlufik [Pologne] ; Maria Kloda [Pologne] ; Andrzej Friedman [Pologne] ; Iwona Potrzebowska [Pologne] ; Kacper Gregier [Pologne] ; Tomasz Mandat [Pologne] ; Andrzej Przybyszewski [Pologne] ; Justyna Dutkiewicz [Pologne] ; Monika Figura [Pologne] ; Piotr Habela [Pologne] ; Dariusz Koziorowski [Pologne]Source :
- Frontiers in neurology [ 1664-2295 ] ; 2018.
Abstract
Background: Subthalamic nucleus deep brain stimulation (STN-DBS) has been an established method in improvement of motor disabilities in Parkinson's disease (PD) patients. It has been also claimed to have an impact on balance and gait disorders in PD patients, but the previous results are conflicting. Objective: The aim of this prospective controlled study was to evaluate the impact of STN-DBS on balance disorders in PD patients in comparison with Best-Medical-Therapy (BMT) and Long-term-Post-Operative (POP) group. Methods: DBS-group consisted of 20 PD patients (8F, 12M) who underwent bilateral STN DBS. POP-group consisted of 14 post-DBS patients (6F, 8M) in median 30 months-time after surgery. Control group (BMT-group) consisted of 20 patients (11F, 9M) who did not undergo surgical intervention. UPDRS III scale and balance tests (Up And Go Test, Dual Task- Timed Up And Go Test, Tandem Walk Test) and posturography parameters were measured during 3 visits in 9 ± 2months periods (V1, V2, V3) 4 phases of treatment (BMT-ON/OFF, DBS-ON/OFF). Results: We have observed the slowdown of gait and postural instability progression in first 9 post-operative months followed by co-existent enhancement of balance disorders in next 9-months evaluation (p < 0.05) in balance tests (Up and Go, TWT) and in posturography examination parameters (p < 0.05). The effect was not observed neither in BMT-group nor POP-group (p > 0.05): these groups revealed constant progression of static and dynamic instability (p > 0.05). Conclusions: STN-DBS can have modulatory effect on static and dynamic instability in PD patients: it can temporarily improve balance disorders. mainly during first 9 post-operative months, but with possible following deterioration of the symptoms in next post-operative months.
DOI: 10.3389/fneur.2018.00906
PubMed: 30429820
PubMed Central: PMC6220087
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<series><title level="j">Frontiers in neurology</title>
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<front><div type="abstract" xml:lang="en"><b>Background:</b>
Subthalamic nucleus deep brain stimulation (STN-DBS) has been an established method in improvement of motor disabilities in Parkinson's disease (PD) patients. It has been also claimed to have an impact on balance and gait disorders in PD patients, but the previous results are conflicting. <b>Objective:</b>
The aim of this prospective controlled study was to evaluate the impact of STN-DBS on balance disorders in PD patients in comparison with Best-Medical-Therapy (BMT) and Long-term-Post-Operative (POP) group. <b>Methods:</b>
DBS-group consisted of 20 PD patients (8F, 12M) who underwent bilateral STN DBS. POP-group consisted of 14 post-DBS patients (6F, 8M) in median 30 months-time after surgery. Control group (BMT-group) consisted of 20 patients (11F, 9M) who did not undergo surgical intervention. UPDRS III scale and balance tests (Up And Go Test, Dual Task- Timed Up And Go Test, Tandem Walk Test) and posturography parameters were measured during 3 visits in 9 ± 2months periods (V1, V2, V3) 4 phases of treatment (BMT-ON/OFF, DBS-ON/OFF). <b>Results:</b>
We have observed the slowdown of gait and postural instability progression in first 9 post-operative months followed by co-existent enhancement of balance disorders in next 9-months evaluation (<i>p</i>
< 0.05) in balance tests (Up and Go, TWT) and in posturography examination parameters (<i>p</i>
< 0.05). The effect was not observed neither in BMT-group nor POP-group (<i>p</i>
> 0.05): these groups revealed constant progression of static and dynamic instability (<i>p</i>
> 0.05). <b>Conclusions:</b>
STN-DBS can have modulatory effect on static and dynamic instability in PD patients: it can temporarily improve balance disorders. mainly during first 9 post-operative months, but with possible following deterioration of the symptoms in next post-operative months.</div>
</front>
</TEI>
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<DateRevised><Year>2020</Year>
<Month>10</Month>
<Day>01</Day>
</DateRevised>
<Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Print">1664-2295</ISSN>
<JournalIssue CitedMedium="Print"><Volume>9</Volume>
<PubDate><Year>2018</Year>
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<Title>Frontiers in neurology</Title>
<ISOAbbreviation>Front Neurol</ISOAbbreviation>
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<ArticleTitle>The Neuromodulatory Impact of Subthalamic Nucleus Deep Brain Stimulation on Gait and Postural Instability in Parkinson's Disease Patients: A Prospective Case Controlled Study.</ArticleTitle>
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<ELocationID EIdType="doi" ValidYN="Y">10.3389/fneur.2018.00906</ELocationID>
<Abstract><AbstractText><b>Background:</b>
Subthalamic nucleus deep brain stimulation (STN-DBS) has been an established method in improvement of motor disabilities in Parkinson's disease (PD) patients. It has been also claimed to have an impact on balance and gait disorders in PD patients, but the previous results are conflicting. <b>Objective:</b>
The aim of this prospective controlled study was to evaluate the impact of STN-DBS on balance disorders in PD patients in comparison with Best-Medical-Therapy (BMT) and Long-term-Post-Operative (POP) group. <b>Methods:</b>
DBS-group consisted of 20 PD patients (8F, 12M) who underwent bilateral STN DBS. POP-group consisted of 14 post-DBS patients (6F, 8M) in median 30 months-time after surgery. Control group (BMT-group) consisted of 20 patients (11F, 9M) who did not undergo surgical intervention. UPDRS III scale and balance tests (Up And Go Test, Dual Task- Timed Up And Go Test, Tandem Walk Test) and posturography parameters were measured during 3 visits in 9 ± 2months periods (V1, V2, V3) 4 phases of treatment (BMT-ON/OFF, DBS-ON/OFF). <b>Results:</b>
We have observed the slowdown of gait and postural instability progression in first 9 post-operative months followed by co-existent enhancement of balance disorders in next 9-months evaluation (<i>p</i>
< 0.05) in balance tests (Up and Go, TWT) and in posturography examination parameters (<i>p</i>
< 0.05). The effect was not observed neither in BMT-group nor POP-group (<i>p</i>
> 0.05): these groups revealed constant progression of static and dynamic instability (<i>p</i>
> 0.05). <b>Conclusions:</b>
STN-DBS can have modulatory effect on static and dynamic instability in PD patients: it can temporarily improve balance disorders. mainly during first 9 post-operative months, but with possible following deterioration of the symptoms in next post-operative months.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Szlufik</LastName>
<ForeName>Stanislaw</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Kloda</LastName>
<ForeName>Maria</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Department of Rehabilitation, II Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Friedman</LastName>
<ForeName>Andrzej</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Potrzebowska</LastName>
<ForeName>Iwona</ForeName>
<Initials>I</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Department of Rehabilitation, II Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Gregier</LastName>
<ForeName>Kacper</ForeName>
<Initials>K</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Mandat</LastName>
<ForeName>Tomasz</ForeName>
<Initials>T</Initials>
<AffiliationInfo><Affiliation>Department of Neurosurgery, Maria Sklodowska Curie Memorial Oncology Center, Warsaw, Warsaw, Poland.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Przybyszewski</LastName>
<ForeName>Andrzej</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Department of Informatics, Polish Japanese Academy of Information Technology, Warsaw, Poland.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Dutkiewicz</LastName>
<ForeName>Justyna</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Figura</LastName>
<ForeName>Monika</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Habela</LastName>
<ForeName>Piotr</ForeName>
<Initials>P</Initials>
<AffiliationInfo><Affiliation>Department of Informatics, Polish Japanese Academy of Information Technology, Warsaw, Poland.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Koziorowski</LastName>
<ForeName>Dariusz</ForeName>
<Initials>D</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2018</Year>
<Month>10</Month>
<Day>31</Day>
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<MedlineTA>Front Neurol</MedlineTA>
<NlmUniqueID>101546899</NlmUniqueID>
<ISSNLinking>1664-2295</ISSNLinking>
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<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">DBS (deep brain stimulation)</Keyword>
<Keyword MajorTopicYN="N">Parkinson's disease</Keyword>
<Keyword MajorTopicYN="N">gait</Keyword>
<Keyword MajorTopicYN="N">instability analysis</Keyword>
<Keyword MajorTopicYN="N">neuromodulation</Keyword>
</KeywordList>
</MedlineCitation>
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<Month>08</Month>
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