Gait analysis in patients with advanced Parkinson disease: different or additive effects on gait induced by levodopa and chronic STN stimulation.
The aim of our study was to observe the effects on gait parameters induced by STN stimulation and levodopa medication in patients with advanced Parkinson's disease in order to determine different or additive effects. Therefore we examined 12 patients with advanced Parkinson disease after bilateral implantation of DBS into the STN. We assessed the motor score of the UPDRS and quantitative gait analysis under 4 treatment conditions: with and without stimulation as well as with and without levodopa. The mean improvement of the UPDRS motor score was almost the same with levodopa and DBS. Combining both therapies we saw a further improvement of the motor score. Gait parameters of patients with PD treated either with levodopa or STN stimulation were greatly improved. A significant difference between levodopa and STN stimulation could only be shown for the parameters velocity and step length. These parameters improved more with levodopa than with stimulation. The combination of both therapeutic methods showed the best results on the UPDRS motor score and gait parameters.
Lubik
S
S
Department of Psychiatry, Staedtische Kliniken Höchst, Frankfurt/Main, Germany. Silke.Lubik@nikocity.de
Fogel
W
W
Tronnier
V
V
Krause
M
M
König
J
J
Jost
W H
WH
D000368:Aged; D000978:Antiparkinson Agents / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D046690:Deep Brain Stimulation; D005684:Gait / Q000187:drug effects*; D006801:Humans; D007866:Leg; D007980:Levodopa / Q000008:administration & dosage*; D008875:Middle Aged; D009043:Motor Activity / Q000187:drug effects; D010300:Parkinson Disease / Q000188:drug therapy*; D011187:Posture; D020127:Recovery of Function / Q000187:drug effects; D012720:Severity of Illness Index; D020531:Subthalamic Nucleus / Q000502:physiology; D016896:Treatment Outcome
D000978:Antiparkinson Agents; D007980:Levodopa