Medication and subthalamic nucleus deep brain stimulation similarly improve balance and complex gait in Parkinson disease.
Medication and subthalamic nucleus deep brain stimulation similarly improve balance and complex gait in Parkinson disease.
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DOI：
10.1016/j.parkreldis.2012.07.013
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发表时间：
2013-01
影响因子：
4.1
通讯作者：
Earhart GM
中科院分区：
文献类型：
--
作者：
McNeely ME;Earhart GM
多巴胺能药物和丘脑底核脑深部电刺激（STN-DBS）可缓解帕金森病的运动症状，但平衡和步态受到的影响更大。余额报告尤其不一致。此外，尽管它们在日常生活中普遍存在，但包括向后和双重任务步态在内的复杂步态情况很少被研究。我们的目的是评估药物、STN-DBS和两种疗法联合使用如何影响平衡和复杂步态。12名帕金森病患者接受了STN-DBS关闭和打开的药物治疗以及STN-DBS关闭和打开的药物治疗。运动障碍采用运动障碍协会统一帕金森病评定量表运动部分（MDS-DBS-III）进行测量。迷你平衡评估系统测试，定时和去，和双重任务定时和去测量平衡和流动性。同时分析了快步向前、尽可能快、向后、双任务向前和双任务向后步态。药物改善了MDS-MRS-III评分、双任务计时和所有步态任务的步长。STN-DBS改善了所有步态任务中的MDS-SRS-III评分、平衡评分、双任务计时起身和行走以及步长和速度。药物和STN-DBS联合治疗并没有提供比单独治疗更大的受益。总体而言，多巴胺能药物和STN-DBS在平衡和步态任务方面提供了类似的改善，尽管STN-DBS的效果更强，可能是由于手术后药物剂量的减少。缺乏治疗的协同效应可能表明两种疗法通过影响相似的神经通路来改善平衡和步态。
Dopaminergic medications and subthalamic nucleus deep brain stimulation (STN-DBS) alleviate motor symptoms in Parkinson disease, but balance and gait are more variably affected. Balance reports are particularly inconsistent. Further, despite their prevalence in daily life, complex gait situations including backward and dual task gait are rarely studied. We aimed to assess how medications, STN-DBS, and both therapies combined affect balance and complex gait. Twelve people with Parkinson disease were evaluated OFF medication with STN-DBS OFF and ON as well as ON medication with STN-DBS OFF and ON. Motor impairment was measured with the Movement Disorder Society Unified Parkinson Disease Rating Scale motor section (MDS-UPDRS-III). The Mini-Balance Evaluations Systems Test, timed-up-and-go, and dual task timed-up-and-go measured balance and mobility. Preferred-pace forward, fast as possible, backward, dual task forward, and dual task backward gait were also analyzed. Medication improved MDS-UPDRS-III scores, dual task timed-up-and-go, and stride length across all gait tasks. STN-DBS improved MDS-UPDRS-III scores, balance scores, dual task timed-up-and-go, and stride length and velocity across all gait tasks. Medication and STN-DBS combined did not provide additional benefits over either therapy alone. Overall, dopaminergic medications and STN-DBS provided similar improvements in balance and gait tasks, although the effects of STN-DBS were stronger, potentially due to reductions in medication doses after surgery. Lack of synergistic effect of treatments may suggest both therapies improve balance and gait by influencing similar neural pathways.
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影响因子：
3.5
作者：
Nilsson, MH;Törnqvist, AL;Rehncrona, S
通讯作者：
Rehncrona, S
影响因子：
3.5
作者：
Franchignoni F;Horak F;Godi M;Nardone A;Giordano A
通讯作者：
Giordano A
影响因子：
11
作者：
Cantiniaux, Stephanie;Vaugoyeau, Marianne;Azulay, Jean-Philippe
通讯作者：
Azulay, Jean-Philippe
影响因子：
6
作者：
Xie, J;Krack, P;Pollak, P
通讯作者：
Pollak, P
影响因子：
8.6
作者：
Hackney, Madeleine E.;Earhart, Gammon M.
通讯作者：
Earhart, Gammon M.