title: Effects of stereotactic neurosurgery on postural instability and gait in Parkinson's disease.
abstract: Postural instability and gait disability (PIGD) are disabling signs of Parkinson's disease. Stereotactic surgery aimed at the internal globus pallidus (GPi) or subthalamic nucleus (STN) might improve PIGD, but the precise effects remain unclear. We performed a systematic review of studies that examined the effects of GPi or STN surgery on PIGD. Most studies examined the effects of bilateral GPi stimulation, bilateral STN stimulation, and unilateral pallidotomy; we, therefore, only performed a meta-analysis on these studies. Bilateral GPi stimulation, bilateral STN stimulation, and to a lesser extent, unilateral pallidotomy significantly improved PIGD, and more so during the ON phase than during the OFF phase.
authors.affiliation: Department of Neurology, University Medical Centre St Radboud, Nijmegen, The Netherlands.
authors.forename: Maaike
authors.initials: M
authors.lastname: Bakker
authors.forename: Rianne A J
authors.initials: RA
authors.lastname: Esselink
authors.forename: Marten
authors.initials: M
authors.lastname: Munneke
authors.forename: Patricia
authors.initials: P
authors.lastname: Limousin-Dowsey
authors.forename: Hans D
authors.initials: HD
authors.lastname: Speelman
authors.forename: Bastiaan R
authors.initials: BR
authors.lastname: Bloem
mesh_terms: D005684:Gait; D005917:Globus Pallidus / Q000601:surgery; D006801:Humans; D010300:Parkinson Disease / Q000503:physiopathology* / Q000601:surgery*; D011187:Posture; D016634:Radiosurgery / Q000295:instrumentation*; D020531:Subthalamic Nucleus / Q000601:surgery; D011795:Surveys and Questionnaires; D013997:Time Factors