Deep brain stimulation effects on gait variability in Parkinson's disease.
The effects of subthalamic nucleus (STN) deep brain stimulation (DBS) on fall risk in patients with Parkinson's disease (PD) currently remain unclear. Although several gait parameters, such as gait speed, have shown improvement with DBS, some studies have reported an increased fall risk following DBS. The purpose of this study was to examine the effect of bilateral DBS on gait variability, a marker of fall risk. The gait of 13 patients with idiopathic PD was analyzed to determine the influence of DBS, levodopa and both therapies together. Following treatment with both levodopa and STN DBS, subjects displayed improved gait speed, reduced gait variability (enhanced stability), and lower Unified Parkinson's Disease Rating Scale (UPDRS) scores. Although UPDRS scores improved with STN DBS alone, parallel improvements were not seen for gait variability. These findings suggest that different mechanisms may contribute to performance on UPDRS motor testing and gait stability in response to DBS.
Hausdorff
Jeffrey M
JM
Tel-Aviv Sourasky Medical Center, Israel. jhausdor@tasmc.health.gov.il
Gruendlinger
Leor
L
Scollins
Lisa
L
O'Herron
Siobhan
S
Tarsy
Daniel
D
D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D000978:Antiparkinson Agents / Q000494:pharmacology / Q000627:therapeutic use; D003131:Combined Modality Therapy; D046690:Deep Brain Stimulation; D005260:Female; D005684:Gait / Q000187:drug effects; D020233:Gait Disorders, Neurologic / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007980:Levodopa / Q000494:pharmacology / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D012306:Risk; D012720:Severity of Illness Index; D020531:Subthalamic Nucleus / Q000503:physiopathology; D016896:Treatment Outcome
D000978:Antiparkinson Agents; D007980:Levodopa