The gait disorder of advanced essential tremor
The gait disorder of advanced essential tremor
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DOI：
10.1093/brain/124.11.2278
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发表时间：
2001-11-01
期刊：
影响因子：
14.5
通讯作者：
Deuschl, G
中科院分区：
文献类型：
--
作者：
Stolze, H;Petersen, G;Deuschl, G
特发性震颤（ET）患者的步态障碍已有轶事描述，但从未进行过定量研究。最近的研究提供了一些 ET 患者出现小脑样手部震颤的证据。因此，我们设计了一项研究来评估腿部功能的小脑样异常。使用三维步态分析系统研究了 25 名 ET 患者、8 名小脑疾病 (CD) 患者和 21 名年龄匹配的健康受试者的正常步态和串联步态。在正常行走过程中，CD 和 ET 患者仅表现出轻微的异常。然而，ET 患者表现出串联步态异常，步错次数增多，且步态广泛、共济失调和失调，这与 CD 患者的表现没有区别。当 ET 患者被分为有或无手部意向性震颤组时，发现意向性震颤组的步态障碍更为明显。患有这种步态障碍的患者日常生活活动受到更严重的干扰，并且患有 ET 晚期。目前的结果定量描述了晚期 ET 中的步态障碍，该障碍影响串联步态，但正常步态几乎不受影响。这是 ET 中存在类似小脑紊乱的有力证据。
Gait disturbances of patients with essential tremor (ET) have been described anecdotally, but have never been investigated quantitatively. Recent studies provided evidence for a cerebellar-like hand tremor in some patients with ET. Therefore, we designed a study to assess cerebellar-like abnormalities of leg function. Twenty-five patients with ET, eight patients with cerebellar diseases (CD) and 21 age-matched healthy subjects were studied for their normal and tandem gait using a three-dimensional gait analysis system. During normal walking, CD and ET patients showed only slight abnormalities. However, ET patients exhibited abnormalities in tandem gait with an increased number of mis-steps and a broad-based, ataxic and dysmetric gait which was indistinguishable from the findings in CD. When ET patients were separated into groups of those with or without intention tremor of the hands, the gait disorder was found to be much more pronounced in the intention tremor group. Patients with this gait disorder were more severely disturbed in their activities of daily living, and suffer from an advanced stage of ET. The present results quantitatively describe a gait disturbance in advanced ET which affects tandem gait, but leaves normal gait almost unaffected. This is strong evidence for a cerebellar-like disturbance in ET.