Effect of bilateral subthalamic nucleus stimulation on parkinsonian gait
Effect of bilateral subthalamic nucleus stimulation on parkinsonian gait
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DOI：
10.1007/s004150170027
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发表时间：
2001-12-01
影响因子：
6
通讯作者：
Pollak, P
中科院分区：
文献类型：
--
作者：
Xie, J;Krack, P;Pollak, P
临床报告显示，双侧丘脑下核（STN）刺激可有效改善帕金森步态。STN刺激对步态的效果的定量分析是有意义的，可以使用市售的步幅分析仪进行。10例帕金森病患者（5男5女），平均年龄55.8岁，SD 9.6岁。他们的帕金森病（PD）平均持续时间为13.3年，SD为4.5年，运动检查评分（统一帕金森病评定量表第三部分）（UPDRS）为43分，非刺激非药物状态下SD为13分。所有患者均在研究前3 ~ 36个月开始进行双侧慢性STN刺激。在有和没有刺激的情况下，对患者进行停药和服药状态的评估。我们分析了主要的步态测量：速度、节奏、步幅、步态周期、单肢和双肢支撑的持续时间。根据UPDRS第三部分评估临床帕金森症状。在非药物状态下，STN刺激显著提高了速度和步幅（p < 0.05）。其效果与左旋多巴相似。在左旋多巴诱导效果最好的时候开启STN刺激，没有观察到进一步的改善。刺激和左旋多巴均显著降低UPDRS运动评分（p < 0.001）。综上所述，STN刺激对帕金森步态是有效的。
Clinical reports show that bilateral subthalamic nucleus (STN) stimulation is effective in improving parkinsonian gait. Quantitative analysis of the efficacy of STN stimulation on gait is of interest and can be carried out using commercially available stride analyser. Ten parkinsonian patients (5 men, 5 women) with a mean age of 55.8, SD 9.6 years were included in our study. They had a mean duration of Parkinson's disease (PD) of 13.3, SD 4.5 years and a motor examination score (part III of the Unified Parkinson's Disease Rating Scale) (UPDRS) of 43, SD 13 in off-stimulation off-drug condition. All the patients had bilateral chronic STN stimulation which had started from 3 to 36 months before the study. Patients were evaluated in off-drug and on-drug conditions both with and without stimulation. We analysed the principal gait measures: velocity, cadence, stride length, gait cycle, duration of single and double limb support. The clinical parkinsonian signs were evaluated with the part III of the UPDRS. In the off-drug condition, STN stimulation significantly (p < 0.05) improved velocity and stride length. The effect was similar to that of levodopa. When STN stimulation was switched on at the best of the levodopa induced effect, no further improvement was observed. The UPDRS motor score was significantly (p < 0.001) decreased after both stimulation and levodopa. In conclusion, STN stimulation is effective on parkinsonian gait.