[Gait disturbance and deep brain stimulation]

Area of Science:

• Neurology
• Neurosurgery
• Movement Disorders

Context:

• Gait disturbance is a common axial symptom in neurological disorders.
• Basal ganglia diseases, such as Parkinson disease and dystonia, frequently cause gait impairment.
• Deep brain stimulation (DBS) has emerged as a significant therapeutic modality.

Purpose:

• To review the efficacy of DBS in treating gait disturbance.
• To compare different DBS targets for specific conditions.
• To highlight emerging targets for gait disorders.

Summary:

• DBS targets for basal ganglia disease-related gait disturbance include the subthalamic nucleus (STN) and globus pallidus internus (GPi).
• Subthalamic nucleus DBS shows greater efficacy for levodopa-responsive parkinsonian gait disturbance compared to globus pallidus internus DBS.
• Globus pallidus internus DBS is effective for primary segmental or generalized dystonia.
• The pedunculopontine tegmental nucleus (PPN) is an emerging target for Parkinson disease gait disturbance.

Impact:

• Provides a comprehensive overview of DBS for gait disorders.
• Informs clinical decision-making regarding DBS target selection.
• Highlights the potential of PPN DBS for Parkinson disease gait disturbance.