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Published on: May 31, 2016
Deep brain stimulation effects on gait variability in Parkinson's disease
Jeffrey M Hausdorff1, Leor Gruendlinger, Lisa Scollins
1Tel-Aviv Sourasky Medical Center, Israel. jhausdor@tasmc.health.gov.il
Summary
Subthalamic nucleus deep brain stimulation (DBS) combined with levodopa improved gait stability and speed in Parkinson's disease (PD) patients. STN-DBS alone improved motor scores but not gait variability, suggesting distinct therapeutic mechanisms.
Area of Science:
- Neurology
- Movement Disorders
- Neuroscience
Background:
- Subthalamic nucleus deep brain stimulation (STN-DBS) is a treatment for Parkinson's disease (PD).
- The impact of STN-DBS on fall risk in PD patients is not fully understood.
- While some gait parameters improve with DBS, others may worsen, potentially increasing fall risk.
Purpose of the Study:
- To investigate the effect of bilateral STN-DBS on gait variability, a key indicator of fall risk.
- To analyze the influence of STN-DBS, levodopa, and their combination on gait parameters in PD patients.
Main Methods:
- Gait analysis was performed on 13 patients with idiopathic Parkinson's disease.
- Evaluated the effects of STN-DBS alone, levodopa alone, and combined therapy.
- Measured gait speed, gait variability, and Unified Parkinson's Disease Rating Scale (UPDRS) scores.
Main Results:
- Combined levodopa and STN-DBS treatment led to improved gait speed and reduced gait variability (enhanced stability).
- Combined therapy also resulted in lower UPDRS scores.
- STN-DBS alone improved UPDRS scores, but gait variability did not show parallel improvement.
Conclusions:
- Combination therapy (levodopa and STN-DBS) enhances gait stability and motor function in Parkinson's disease.
- STN-DBS and levodopa may act through different mechanisms to improve motor symptoms and gait stability.
- Gait variability is a crucial marker for assessing fall risk and treatment efficacy in PD patients undergoing DBS.
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