Related Experiment Video
Updated: Jul 7, 2026
07:14
A Novel Approach to Assess Motor Outcome of Deep Brain Stimulation Effects in the Hemiparkinsonian Rat: Staircase and Cylinder Test
Published on: May 31, 2016
Subthalamic nucleus stimulation and levodopa-resistant postural instability in Parkinson's disease
Jasper E Visser1, John H J Allum, Mark G Carpenter
1Dept. of Neurology (HP 935), Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Journal of Neurology
|February 16, 2008
Summary
Subthalamic nucleus stimulation did not improve levodopa-resistant balance issues in Parkinson's disease patients. Pre-existing axial motor symptoms correlated with worse outcomes, suggesting STN stimulation is not effective for this specific patient group.
Area of Science:
- Neurology
- Neurosurgery
- Movement Disorders
Background:
- Parkinson's disease (PD) often involves levodopa-resistant postural instability.
- Subthalamic nucleus (STN) deep brain stimulation (DBS) is a treatment for PD motor symptoms.
- The efficacy of STN DBS for levodopa-resistant balance impairment remains unclear.
Purpose of the Study:
- To investigate the effect of bilateral STN stimulation on levodopa-resistant postural instability in Parkinson's disease patients.
- To assess whether STN stimulation improves quantitative measures of balance control.
Main Methods:
- 14 Parkinson's disease patients and 18 controls underwent quantitative posturography.
- Patients were tested with STN stimulators ON and OFF after levodopa administration.
- Backward directed perturbations were used to assess instability.
Main Results:
- Parkinson's disease patients (stimulators OFF) showed greater instability than controls during backward perturbations.
- STN stimulation did not significantly improve overall postural instability in the patient group.
- A significant inter-individual variability in response to STN stimulation was observed.
- Pre-operative levodopa-resistant axial motor symptoms correlated with a negative treatment effect.
Conclusions:
- Bilateral STN stimulation does not alleviate levodopa-resistant postural instability in Parkinson's disease.
- Pre-existing severe axial motor symptoms may predict a poor response to STN DBS for balance.
- Further research is needed to identify predictors of treatment response in PD.
Related Concept Videos
01:24Parkinson's Disease: Treatment
Neurodegenerative disorders, such as Parkinson's Disease (PD), involve the gradual and irreversible destruction of neurons in particular brain areas. These disorders exhibit standard features like proteinopathies, selective vulnerability of some neurons, and an interaction of intrinsic properties, genetics, and environmental influences in neural injury.
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of its...
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of its...
01:24Parkinson Disease ll: Pathophysiology
Parkinson disease (PD) is a progressive neurodegenerative disorder primarily affecting movement, with additional non-motor features. Its pathophysiology involves complex interactions among genetic susceptibility, environmental exposures, and cellular dysfunction, including dopaminergic neuron loss, protein aggregation, and mitochondrial impairment.Selective NeurodegenerationA key feature is the degeneration of dopaminergic neurons in the substantia nigra pars compacta, leading to reduced...
01:15Parkinson's Disease: Overview
Neurodegenerative disorders are progressive diseases that cause irreversible damage and loss to neurons in specific brain areas. Examples of these disorders include Parkinson's disease, Alzheimer's disease, Multiple Sclerosis (MS), and Amyotrophic Lateral Sclerosis (ALS). These disorders share characteristics such as proteinopathies, selective neuronal vulnerability, and a complex interplay between genetic and environmental factors. The primary therapeutic goal for these conditions is to...
01:24Parkinson Disease l: Introduction
Parkinson’s disease is a chronic, progressive neurodegenerative disorder that primarily affects movement. It is characterized by motor symptoms such as resting tremors, muscle rigidity, bradykinesia (slowness of movement), and postural instability. Patients may notice hand tremors at rest, stiffness during movement, or a shuffling gait. In addition to motor features, non-motor symptoms include sleep disturbances, mood and behavioral changes, constipation, and cognitive impairment, all of which...
01:11Alterations in Muscle Tone lll
Rigidity and myotonia are distinct abnormalities of muscle tone that affect resistance and relaxation during movement. Although both involve altered muscle contraction, they arise from different neurological and muscular mechanisms.CharacteristicsRigidity is characterized by uniform resistance to passive movement across the entire range, independent of speed, affecting flexors and extensors equally. It may appear as lead-pipe rigidity (smooth, constant resistance) or cogwheel rigidity...
01:37Neural Regulation
Digestion begins with a cephalic phase that prepares the digestive system to receive food. When our brain processes visual or olfactory information about food, it triggers impulses in the cranial nerves innervating the salivary glands and stomach to prepare for food.