Document Detail

Comparative analysis of the gait disorder of normal pressure hydrocephalus and Parkinson's disease.
MedLine Citation:
PMID:  11181848     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Comparative gait analyses in neurological diseases interfering with locomotion are of particular interest, as many hypokinetic gait disorders have the same main features. The aim of the present study was (1) to compare the gait disturbance in normal pressure hydrocephalus and Parkinson's disease; (2) to evaluate which variables of the disturbed gait pattern respond to specific treatment in both diseases; and (3) to assess the responsiveness to visual and acoustic cues for gait improvement. METHODS: In study 1 gait analysis was carried out on 11 patients with normal pressure hydrocephalus, 10 patients with Parkinson's disease, and 12 age matched healthy control subjects, on a walkway and on a treadmill. In study 2, patients with normal pressure hydrocephalus were reinvestigated after removal of 30 ml CSF, and patients with Parkinson's disease after administration of 150 mg levodopa. In part 3 visual cues were provided as stripes fixed on the walkway and acoustic cues as beats of a metronome. RESULTS: The gait disorder in both diseases shared the feature of a reduced gait velocity, due to a diminished and highly variable stride length. Specific features of the gait disturbance in normal pressure hydrocephalus were a broad based gait pattern with outward rotated feet and a diminished height of the steps. After treatment in both diseases, the speed increased, due to an enlarged stride length, now presenting a lower variability. All other gait variables remained unaffected. External cues only mildly improved gait in normal pressure hydrocephalus, whereas they were highly effective in raising the stride length and cadence in Parkinson's disease. CONCLUSION: The gait pattern in normal pressure hydrocephalus is clearly distinguishable from the gait of Parkinson's disease. As well as the basal ganglia output connections, other pathways and structures most likely in the frontal lobes are responsible for the gait pattern and especially the disturbed dynamic equilibrium in normal pressure hydrocephalus. Hypokinesia and its responsiveness to external cues in both diseases are assumed to be an expression of a disturbed motor planning.
H Stolze; J P Kuhtz-Buschbeck; H Drücke; K Jöhnk; M Illert; G Deuschl
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of neurology, neurosurgery, and psychiatry     Volume:  70     ISSN:  0022-3050     ISO Abbreviation:  J. Neurol. Neurosurg. Psychiatr.     Publication Date:  2001 Mar 
Date Detail:
Created Date:  2001-02-22     Completed Date:  2001-04-12     Revised Date:  2010-09-14    
Medline Journal Info:
Nlm Unique ID:  2985191R     Medline TA:  J Neurol Neurosurg Psychiatry     Country:  England    
Other Details:
Languages:  eng     Pagination:  289-97     Citation Subset:  IM    
Department of Neurology, Christian-Albrechts-Universität zu Kiel, Niemannsweg 147, D-24105 Kiel, Germany.
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MeSH Terms
Gait Disorders, Neurologic / physiopathology*
Hydrocephalus, Normal Pressure / physiopathology*
Middle Aged
Parkinson Disease / physiopathology*
Comment In:
J Neurol Neurosurg Psychiatry. 2001 Mar;70(3):288   [PMID:  11181847 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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