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Effects of bilateral pallidal or subthalamic stimulation on gait in advanced Parkinson's disease
Author(s) -
Allert N.,
Volkmann J.,
Dotse S.,
Hefter H.,
Sturm V.,
Freund H.J.
Publication year - 2001
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.1222
Subject(s) - subthalamic nucleus , parkinson's disease , cadence , deep brain stimulation , gait , basal ganglia , physical medicine and rehabilitation , globus pallidus , stimulation , psychology , gait analysis , central nervous system disease , rating scale , medicine , physical therapy , neuroscience , disease , central nervous system , developmental psychology
Bilateral high‐frequency stimulation of the internal globus pallidus (GPi) and the subthalamic nucleus (STN) both alleviate akinesia, rigidity, and tremor in idiopathic Parkinson's disease. To test the specific effect of these procedures on gait, we used quantitative gait analysis in addition to relevant subscores of the Unified Parkinson's Disease Rating Scale in a group of 10 patients with advanced Parkinson's disease treated by GPi stimulation and eight patients treated by STN stimulation. Patients were assessed before and 3 months after surgery. Thirty age‐matched healthy subjects served as controls. The non‐random selection allowed a descriptive but no direct statistical comparison of the respective procedure. Gait analysis showed significant stimulation‐induced improvements of spatiotemporal gait and step parameters in both patient groups. Moreover, the effects on step length and cadence suggested a differential effect of both basal ganglia targets. Hence, the increase in gait velocity in the STN group was almost exclusively due to a significant increase in step length, while in the GPi group statistically non‐significant increases in both step length and cadence contributed. © 2001 Movement Disorder Society.