Impact of sub-thalamic nucleus deep brain stimulation on dual tasking gait in Parkinson's disease.
Impact of sub-thalamic nucleus deep brain stimulation on dual tasking gait in Parkinson's disease.
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DOI：
10.1186/1743-0003-10-38
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发表时间：
2013-04-15
影响因子：
5.1
通讯作者：
Hausdorff JM
中科院分区：
文献类型：
--
作者：
Seri-Fainshtat E;Israel Z;Weiss A;Hausdorff JM
双侧丘脑下核深部脑刺激对晚期帕金森病的运动功能和步态的有益影响已被证实。关于刺激对认知功能和双重任务时行走能力的影响知之甚少，这种能力与跌倒风险有关。日常步行是在复杂的环境中进行的，通常需要同时处理多项任务。因此，双任务步态表现反映了日常行走以及步态自动化。本研究的目的是检查丘脑下核深部脑刺激对晚期帕金森病患者双重任务步行的影响。使用基于表现的测试以及量化 28 名晚期帕金森病患者的单任务和双任务步行状况来评估步态。这些测试在 4 种条件下进行：“关闭”药物（刺激器打开和关闭）和“开启”药物（刺激器打开和关闭）。在受试者服用抗帕金森病药物后，先前经过验证的计算机化神经心理电池评估了“关闭”和“开启”深部脑刺激的执行功能、注意力和记忆力。在单任务和双任务步行条件下，刺激改善了运动功能和步态时空参数（例如步态速度）。注意力有所改善，但执行功能却没有。双重任务对步态的影响不会因刺激而改变。例如，在连续 3 次减法过程中，关闭 DBS 和关闭药物时步态速度降低 -0.20 ± 0.14 m/sec，打开 DBS 时步态速度降低 -0.22±0.14 m/sec (p=0.648)。同样，在药物治疗中，连续 3 次减法使 DBS 下的步态速度降低了 -0.20 ± 0.16 m/sec，DBS 上降低了 -0.22± 0.09 m/sec (p = 0.543)。双侧丘脑下核深部脑刺激可改善运动症状、步态的某些特征，甚至认知功能的某些方面。然而，刺激显然无法减少双重任务对步行能力的负面影响。这些发现为认知挑战条件下和日常行走时深部脑刺激对步态的影响提供了新的见解。
The beneficial effects of bilateral sub-thalamic nucleus deep brain stimulation on motor function and gait in advanced Parkinson’s disease are established. Less is known about the effect of stimulation on cognitive function and the capacity to walk while dual tasking, an ability that has been related to fall risk. Everyday walking takes place in complex environments that often require multi-tasking. Hence, dual tasking gait performance reflects everyday ambulation as well as gait automaticity. The purpose of this study was to examine the impact of sub-thalamic nucleus deep brain stimulation on dual task walking in patients with advanced Parkinson’s disease. Gait was assessed using a performance-based test and by quantifying single-task and dual task walking conditions in 28 patients with advanced Parkinson’s disease. These tests were conducted in 4 conditions: “OFF” medication, with the stimulator turned on and off, and “ON” medication, with the stimulator turned on and off. A previously validated, computerized neuro-psychological battery assessed executive function, attention and memory “OFF” and “ON” deep brain stimulation, after subjects took their anti-Parkinsonian medications. Stimulation improved motor function and the spatiotemporal parameters of gait (e.g., gait speed) during both single-task and dual task walking conditions. Attention improved, but executive function did not. The dual task effect on gait did not change in response to stimulation. For example, during serial 3 subtractions, gait speed was reduced by -0.20 ± 0.14 m/sec while OFF DBS and OFF meds and by -0.22 ± 0.14 m/sec when the DBS was turned on (p = 0.648). Similarly, ON medication, serial 3 subtractions reduced gait speed by -0.20 ± 0.16 m/sec OFF DBS and by -0.22 ± 0.09 m/sec ON DBS (p = 0.543). Bilateral sub-thalamic nucleus deep brain stimulation improves motor symptoms, certain features of gait and even some aspects of cognitive function. However, stimulation apparently fails to reduce the negative impact of a dual task on walking abilities. These findings provide new insight into the effects of deep brain stimulation on gait during cognitively challenging conditions and everyday walking.
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影响因子：
158.5
作者：
Follett, Kenneth A.;Weaver, Frances M.;Reda, Domenic J.
通讯作者：
Reda, Domenic J.
影响因子：
4.4
作者：
BLIN, O;FERRANDEZ, AM;SERRATRICE, G
通讯作者：
SERRATRICE, G
影响因子：
3.3
作者：
Caliandro, Pietro;Insola, A.;Mazzone, P.
通讯作者：
Mazzone, P.
影响因子：
1.9
作者：
Davis, Justin T.;Lyons, Kelly E.;Pahwa, Rajesh
通讯作者：
Pahwa, Rajesh
影响因子：
11
作者：
Bejjani, BP;Gervais, D;Agid, Y
通讯作者：
Agid, Y