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20.05.2023 | Original Communication

Long-term effects of bilateral subthalamic nucleus deep brain stimulation on gait disorders in Parkinson’s disease: a clinical-instrumental study

verfasst von: Francesco Cavallieri, Isabella Campanini, Annalisa Gessani, Carla Budriesi, Valentina Fioravanti, Giulia Di Rauso, Alberto Feletti, Benedetta Damiano, Sara Scaltriti, Noemi Guagnano, Elisa Bardi, Maria Giulia Corni, Jessica Rossi, Francesca Antonelli, Francesca Cavalleri, Maria Angela Molinari, Sara Contardi, Elisa Menozzi, Annette Puzzolante, Giuseppe Vannozzi, Elena Bergamini, Giacomo Pavesi, Sara Meoni, Valérie Fraix, Alessandro Fraternali, Annibale Versari, Mirco Lusuardi, Giuseppe Biagini, Andrea Merlo, Elena Moro, Franco Valzania

Erschienen in: Journal of Neurology | Ausgabe 9/2023

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Abstract

Objective

To assess the long-term effects of bilateral subthalamic nucleus deep brain stimulation (STN-DBS) on gait in a cohort of advanced Parkinson’s Disease (PD) patients.

Methods

This observational study included consecutive PD patients treated with bilateral STN-DBS. Different stimulation and drug treatment conditions were assessed: on-stimulation/off-medication, off-stimulation/off-medication, and on-stimulation/on-medication. Each patient performed the instrumented Timed Up and Go test (iTUG). The instrumental evaluation of walking ability was carried out with a wearable inertial sensor containing a three-dimensional (3D) accelerometer, gyroscope, and magnetometer. This device could provide 3D linear acceleration, angular velocity, and magnetic field vector. Disease motor severity was evaluated with the total score and subscores of the Unified Parkinson Disease Rating Scale part III.

Results

Twenty-five PD patients with a 5-years median follow-up after surgery (range 3–7) were included (18 men; mean disease duration at surgery 10.44 ± 4.62 years; mean age at surgery 58.40 ± 5.73 years). Both stimulation and medication reduced the total duration of the iTUG and most of its different phases, suggesting a long-term beneficial effect on gait after surgery. However, comparing the two treatments, dopaminergic therapy had a more marked effect in all test phases. STN-DBS alone reduced total iTUG duration, sit-to-stand, and second turn phases duration, while it had a lower effect on stand-to-sit, first turn, forward walking, and walking backward phases duration.

Conclusions

This study highlighted that in the long-term after surgery, STN-DBS may contribute to gait and postural control improvement when used together with dopamine replacement therapy, which still shows a substantial beneficial effect.

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Titel: Long-term effects of bilateral subthalamic nucleus deep brain stimulation on gait disorders in Parkinson’s disease: a clinical-instrumental study
verfasst von: Francesco Cavallieri
Isabella Campanini
Annalisa Gessani
Carla Budriesi
Valentina Fioravanti
Giulia Di Rauso
Alberto Feletti
Benedetta Damiano
Sara Scaltriti
Noemi Guagnano
Elisa Bardi
Maria Giulia Corni
Jessica Rossi
Francesca Antonelli
Francesca Cavalleri
Maria Angela Molinari
Sara Contardi
Elisa Menozzi
Annette Puzzolante
Giuseppe Vannozzi
Elena Bergamini
Giacomo Pavesi
Sara Meoni
Valérie Fraix
Alessandro Fraternali
Annibale Versari
Mirco Lusuardi
Giuseppe Biagini
Andrea Merlo
Elena Moro
Franco Valzania
Publikationsdatum: 20.05.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Neurology / Ausgabe 9/2023
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-023-11780-5

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