Subthalamic nucleus stimulation and levodopa-resistant postural instability in Parkinson's disease

被引：47

作者：

Visser, Jasper E. ^{[1
,2
]}

Allum, John H. J. ^{[2
]}

Carpenter, Mark G. ^{[2
,3
]}

Esselink, Rianne A. ^{[1
,4
]}

Speelman, Johannes D. ^{[5
]}

Borm, George F. ^{[6
]}

Bloem, Bastiaan R. ^{[1
]}

机构：

[1] Radboud Univ Nijmegen, Med Ctr, Dept Neurol, NL-6500 HB Nijmegen, Netherlands

[2] Univ Basel Hosp, Dept Otorhinolaryngol, Basel, Switzerland

[3] Univ British Columbia, Sch Human Kinet, Vancouver, BC V5Z 1M9, Canada

[4] Radboud Univ Nijmegen, Med Ctr, Dept Geriatr, Nijmegen, Netherlands

[5] Univ Hosp Amsterdam, Acad Med Ctr, Dept Neurol, Amsterdam, Netherlands

[6] Radboud Univ Nijmegen, Med Ctr, Dept Epidemiol & Biostat, Nijmegen, Netherlands

来源：

JOURNAL OF NEUROLOGY | 2008年 / 255卷 / 02期

关键词：

Parkinson's disease; postural instability; subthalamic nucleus; deep brain surgery; posturography;

D O I：

10.1007/s00415-008-0636-x

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

We examined the effect of bilateral subthalamic nucleus stimulation on levodopa-resistant balance impairment in 14 patients with Parkinson's disease and 18 matched controls. Instability was quantitatively assessed using standardized multidirectional dynamic posturography. Patients were tested after taking a suprathreshold dose of levodopa, both with stimulators turned on and off. Patients with stimulators turned off were more unstable than controls following backward directed perturbations. Overall, patients' instability did not improve with STN stimulation, and considerable inter-individual variability was noted. Of note, marked levodopa-resistant axial motor symptoms before surgery correlated with an adverse treatment effect. We conclude that STN stimulation does not alleviate levodopa-resistant postural instability in Parkinson's disease.

引用

页码：205 / 210

页数：6

共 27 条

[1] Age-dependent variations in the directional sensitivity of balance corrections and compensatory arm movements in man [J].

Allum, JHJ ;

Carpenter, MG ;

Honegger, F ;

Adkin, AL ;

Bloem, BR .

JOURNAL OF PHYSIOLOGY-LONDON, 2002, 542 (02) :643-663

[2] Effects of stereotactic neurosurgery on postural instability and gait in Parkinson's disease [J].

Bakker, M ;

Esselink, RAJ ;

Munneke, M ;

Limousin-Dowsey, P ;

Speelman, HD ;

Bloem, BR .

MOVEMENT DISORDERS, 2004, 19 (09) :1092-1099

[3] Axial parkinsonian symptoms can be improved: the role of levodopa and bilateral subthalamic stimulation [J].

Bejjani, BP ;

Gervais, D ;

Arnulf, I ;

Papadopoulos, S ;

Demeret, S ;

Bonnet, AM ;

Cornu, P ;

Damier, P ;

Agid, Y .

JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 2000, 68 (05) :595-600

[4]

Bloem B.R., 2004, Clin. Disord. Balanc. Posture Gait, P173

[5]

BLOEM BR, 2003, MOVEMENT NEUROPHYSIO, P295

[6] Deceleration affects anticipatory and reactive components of triggered postural responses [J].

Carpenter, MG ;

Thorstensson, A ;

Cresswell, AG .

EXPERIMENTAL BRAIN RESEARCH, 2005, 167 (03) :433-445

[7] Postural abnormalities to multidirectional stance perturbations in Parkinson's disease [J].

Carpenter, MG ;

Allum, JHJ ;

Honegger, F ;

Adkin, AL ;

Bloem, BR .

JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 2004, 75 (09) :1245-1254

[8] Predictors of effective bilateral subthalamic nucleus stimulation for PD [J].

Charles, PD ;

Van Blercom, N ;

Krack, P ;

Lee, SL ;

Xie, J ;

Besson, G ;

Benabid, AL ;

Pollak, P .

NEUROLOGY, 2002, 59 (06) :932-934

[9] Bilateral subthalamic nucleus stimulation improves balance control in Parkinson's disease [J].

Colnat-Coulbois, S ;

Gauchard, GC ;

Maillard, L ;

Barroche, G ;

Vespignani, H ;

Auque, J ;

Perrin, PP .

JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 2005, 76 (06) :780-787

[10] Unilateral pallidotomy versus bilateral subthalamic nucleus stimulation in PD - A randomized trial [J].

Esselink, RAJ ;

de Bie, RMA ;

de Haan, RJ ;

Lenders, MWPM ;

Nijssen, PCG ;

Staal, MJ ;

Smeding, HMM ;

Schuurman, PR ;

Bosch, DA ;

Speelman, JD .

NEUROLOGY, 2004, 62 (02) :201-207

← 1 2 3 →