title: Normal and pathological gait: what we learn from Parkinson's disease.
abstract: Gait and balance disorders represent a major therapeutic challenge in Parkinson's disease (PD). These symptoms respond poorly to dopaminergic treatments, except in the early phase of the disease. Currently, no other treatment is particularly efficient and rehabilitation appears to be the most effective approach. Since these gait and balance deficits are resistant to dopaminergic drugs, their occurrence could be related to the development of extradopaminergic lesions in PD patients. We provide a comprehensive description of the clinical features of gait and balance disorders in PD. We also highlight the brain networks involved in gait and balance control in animals and humans with a particular focus on the relevant structures in the context of PD, such as the mesencephalic locomotor region. We also review other neuronal systems that may be involved in the physiopathology of gait and balance disorders in PD (noradrenergic and serotoninergic systems, cerebellum and cortex). In addition, we review recent evidence regarding functional neurosurgery for gait disorders in PD and propose new directions for future therapeutic research.
authors: Université Pierre et Marie Curie-Paris 6, CR-ICM, UMR-S975, Paris, France.
authors: David
authors: D
authors: Grabli
authors: Carine
authors: C
authors: Karachi
authors: Marie-Laure
authors: ML
authors: Welter
authors: Brian
authors: B
authors: Lau
authors: Etienne C
authors: EC
authors: Hirsch
authors: Marie
authors: M
authors: Vidailhet
authors: Chantal
authors: C
authors: François
mesh_terms: D000058:Accidental Falls; D001933:Brain Stem / Q000378:metabolism / Q000503:physiopathology; D002531:Cerebellum / Q000378:metabolism / Q000503:physiopathology; D002540:Cerebral Cortex / Q000378:metabolism / Q000503:physiopathology; D018849:Controlled Clinical Trials as Topic; D046690:Deep Brain Stimulation; D004298:Dopamine / Q000378:metabolism; D004837:Epinephrine / Q000378:metabolism; D005684:Gait / Q000502:physiology; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D010300:Parkinson Disease / Q000150:complications / Q000378:metabolism / Q000503:physiopathology* / Q000628:therapy; D004856:Postural Balance; D012701:Serotonin / Q000378:metabolism
chemical_list: D012701:Serotonin; D004298:Dopamine; D004837:Epinephrine