Effect of subthalamic nucleus deep brain stimulation on balance in Parkinson’s disease: A static posturographic analysis |
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| Institution: | 1. Movement Disorders Unit, Neurology Department, Hospital General Universitario Gregorio Marañón, Calle Doctor Esquerdo n°46, 28007, Madrid, Spain;2. Movement Disorders Unit, Neurology Department, Hospital Universitario Clínico San Carlos, Calle del Prof Martín Lagos, s/n, 28040, Madrid, Spain;1. UNAM, Pôle Recherche & Innovation, Fondation Ellen Poidatz, 1 Rue Ellen Poidatz, Saint-Fargeau-Ponthierry, France;2. IBISC—EA 4526, Université d’Evry Val d’Essonne, 40 Rue du Pelvoux, Courcouronnes, France;3. SAMOVAR—UMR 5157, Télécom SudParis, Institut Mines-Télécom, 9 Rue Charles Fourier, Evry, France;4. Chirurgie Orthopédique Pédiatrique, Hôpital Universitaire Necker-Enfants Malades, 149 Rue de Sèvres, Paris, France;1. Landon Center on Aging, University of Kansas Medical Center, Kansas City, KS;2. Department of Neurology, Oregon Health and Science University, Portland, OR;3. Neurology Department, Portland Veterans Affairs Medical Center, Portland, OR;1. Paediatric Orthopaedic Unit, Department of Paediatric Surgery, Medical University of Graz, Auenbruggerplatz 34, A-8036 Graz, Austria;2. Institute of Sport Science, University of Graz, Mozartgasse 14/I, A-8010 Graz, Austria;1. Australian Catholic University, School of Exercise Science, Banyo, Queensland, Australia;2. University of Portsmouth, Department of Sport and Exercise Science, Hampshire, United Kingdom;3. Asia-Pacific Centre for Neuromodulation, Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia;1. Area of Neuroscience, SISSA, Trieste, Italy;2. S.O.C. Neurologia, Azienda Ospedaliero Universitaria “Santa Maria della Misericordia”, Udine, Italy;3. S.O.C. Neurochirurgia, Azienda Ospedaliero Universitaria “Santa Maria della Misericordia”, Udine, Italy |
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| Abstract: | BackgroundThe effect of subthalamic deep brain stimulation on balance in Parkinson’s disease remains unclear.ObjectiveTo evaluate the effect of subthalamic nucleus stimulation on balance in Parkinson’s disease using posturography.Methods16 patients (9 women) who underwent subthalamic deep brain stimulation mean age 59.6 years (46–70); mean disease duration 15.6 years (7–25); mean duration of subthalamic stimulation 32.1 months (3.0–69.6)] and 13 healthy age-matched controls were evaluated using a static posturography analysis. Patients were assessed under four conditions: 1) off medication/off stimulation; 2) off medication/on stimulation; 3) on medication/off stimulation and 4) on medication/on stimulation in ten experimental paradigms, some reproducing common situations of daily living. The displacement of the centre of pressure was analyzed using 14 posturographic parameters. The Mann-Whitney test was used to compare patients with controls. The Wilcoxon signed rank test was used to compare patients under different clinical conditions.ResultsPatients off medication/off stimulation showed larger and more rapid displacements of the centre of pressure than controls in most paradigms (p < 0.05), particularly when performing a dual task. Subthalamic stimulation alone reduced the lateral excursion and anterior-posterior velocity of the centre of pressure in quite stance paradigms (p < 0.05). Subthalamic stimulation combined with antiparkinsonian medication did not induce statistically significant changes in posturagraphic measures in any experimental paradigm.ConclusionsAlthough subthalamic stimulation alone may induce some positive effect on balance, subthalamic stimulation in addition to antiparkinsonian medication, which is the usual treatment in clinical practice, did not modify balance as assessed by static posturography in patients with Parkinson’s disease. |
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| Keywords: | Subthalamic nucleus Deep brain stimulation Balance Posturography |
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