Subthalamic nucleus stimulation and levodopa-resistant postural instability in Parkinson's disease.
We examined the effect of bilateral subthalamic nucleus stimulation on levodopa-resistant balance impairment in 14 patients with Parkinson's disease and 18 matched controls. Instability was quantitatively assessed using standardized multidirectional dynamic posturography. Patients were tested after taking a suprathreshold dose of levodopa, both with stimulators turned on and off. Patients with stimulators turned off were more unstable than controls following backward directed perturbations. Overall, patients' instability did not improve with STN stimulation, and considerable inter-individual variability was noted. Of note, marked levodopa- resistant axial motor symptoms before surgery correlated with an adverse treatment effect. We conclude that STN stimulation does not alleviate levodopa-resistant postural instability in Parkinson's disease.
Visser
Jasper E
JE
Dept. of Neurology (HP 935), Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Allum
John H J
JH
Carpenter
Mark G
MG
Esselink
Rianne A
RA
Speelman
Johannes D
JD
Borm
George F
GF
Bloem
Bastiaan R
BR
D000328:Adult; D000978:Antiparkinson Agents / Q000627:therapeutic use*; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D004856:Postural Balance / Q000187:drug effects / Q000502:physiology*; D011187:Posture / Q000502:physiology*; D020531:Subthalamic Nucleus / Q000502:physiology*; D016896:Treatment Outcome
D000978:Antiparkinson Agents; D007980:Levodopa