Document Detail

Impact of subthalamic nucleus stimulation on the initiation of gait in Parkinson's disease.
MedLine Citation:
PMID:  16555105     Owner:  NLM     Status:  MEDLINE    
The effects of subthalamic nucleus (STN) stimulation on the anticipatory postural actions associated with the initiation of gait were studied in ten patients with idiopathic Parkinson's disease undergoing therapeutic deep brain stimulation. Kinematic, dynamic and electromyographic analysis was performed before and while subjects were starting gait in response to an external cue. Effects of STN stimulation on the standing posture preceding the go signal included significant improvement of the vertical alignment of the trunk and shank, decrease of the hip joint moment, backward shift of the center of pressure (CoP) and reduction of abnormal tonic and/or rhythmic activity in the thigh and leg muscles. Responses to bilateral STN stimulation were more consistent than those evoked by unilateral stimulation. Moreover, comparison between postural changes induced by STN stimulation applied prior to the gait initiation cue and during simple quiet standing revealed more significant responses in the former condition. Effects on the actual gait initiation process included shortening of the imbalance phase, larger backward/lateral displacement of CoP and more physiological expression of the underlying anticipatory muscular synergy. Additional changes were shortening of the unloading phase, shortening of the first-swing phase and increase in the length of the first step. Results demonstrate substantial influence of STN stimulation on functionally basic motor control mechanisms. In particular, the evidence of more significant responses upon attention-demanding conditions and the remarkable effects on postural programmes sub-serving feed-forward regulation of the onset of complex multijoint movements, suggests a consistent action on postural sub-systems relying on cognitive data processing and internal models of body mechanics.
P Crenna; I Carpinella; M Rabuffetti; M Rizzone; L Lopiano; M Lanotte; M Ferrarin
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-03-23
Journal Detail:
Title:  Experimental brain research     Volume:  172     ISSN:  0014-4819     ISO Abbreviation:  Exp Brain Res     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-06-29     Completed Date:  2007-01-26     Revised Date:  2013-12-13    
Medline Journal Info:
Nlm Unique ID:  0043312     Medline TA:  Exp Brain Res     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  519-32     Citation Subset:  IM    
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MeSH Terms
Analysis of Variance
Biomechanical Phenomena
Deep Brain Stimulation / methods*
Electromyography / methods
Gait / radiation effects*
Middle Aged
Parkinson Disease / physiopathology,  therapy*
Postural Balance / physiology,  radiation effects*
Posture / physiology*
Subthalamic Nucleus / physiopathology,  radiation effects*

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

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