Deep brain stimulation effect on postural instability and gait disorders in Parkinson's disease

2019 ◽  
Vol 119 (9) ◽  
pp. 123
Author(s):  
S. G. Sultanova ◽  
N. V. Fedorova ◽  
E. V. Bril ◽  
A. A. Gamaleya ◽  
A. A. Tomskiy
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Postural Instability ◽  
Gait Disorders ◽  
Deep Brain

Postural instability and gait disorders after subthalamic nucleus deep brain stimulation in Parkinson’s disease: a PET study

2019 ◽  
Vol 266 (11) ◽  
pp. 2764-2771 ◽  
Author(s):  
Kévin Ahrweiller ◽  
J. F. Houvenaghel ◽  
A. Riou ◽  
S. Drapier ◽  
P. Sauleau ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Subthalamic Nucleus ◽  
Brain Stimulation ◽  
Postural Instability ◽  
Gait Disorders ◽  
Deep Brain

scholarly journals Predictors of Functional and Quality of Life Outcomes following Deep Brain Stimulation Surgery in Parkinson’s Disease Patients: Disease, Patient, and Surgical Factors

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Hesham Abboud ◽  
Gencer Genc ◽  
Nicolas R. Thompson ◽  
Srivadee Oravivattanakul ◽  
Faisal Alsallom ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Postural Instability ◽  
Functional Scores ◽  
Global Impression Of Change ◽  
Deep Brain

Objective. The primary objective was to evaluate predictors of quality of life (QOL) and functional outcomes following deep brain stimulation (DBS) in Parkinson’s disease (PD) patients. The secondary objective was to identify predictors of global improvement. Methods. PD patients who underwent DBS at our Center from 2006 to 2011 were evaluated by chart review and email/phone survey. Postoperative UPDRS II and EQ-5D were analyzed using simple linear regression adjusting for preoperative score. For global outcomes, we utilized the Patient Global Impression of Change Scale (PGIS) and the Clinician Global Impression of Change Scale (CGIS). Results. There were 130 patients in the dataset. Preoperative and postoperative UPDRS II and EQ-5D were available for 45 patients, PGIS for 67 patients, and CGIS for 116 patients. Patients with falls/postural instability had 6-month functional scores and 1-year QOL scores that were significantly worse than patients without falls/postural instability. For every 1-point increase in preoperative UPDRS III and for every 1-unit increase in body mass index (BMI), the 6-month functional scores significantly worsened. Patients with tremors, without dyskinesia, and without gait-freezing were more likely to have “much” or “very much” improved CGIS. Conclusions. Presence of postural instability, high BMI, and worse baseline motor scores were the greatest predictors of poorer functional and QOL outcomes after DBS.

scholarly journals Deep brain stimulation in the treatment of Parkinson’s disease

2021 ◽  
Author(s):  
Bruna Alves Rocha ◽  
Lucas Oliveira Braga ◽  
Julia Beatriz Xavier do Nascimento ◽  
Angela dos Santos Avakian
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Meta Analysis ◽  
Postural Instability ◽  
Motor Symptoms ◽  
Subcortical Structures ◽  
Pubmed Database ◽  
Deep Brain

Introduction: Parkinson’s disease (PD) is neurodegenerative and has bradykinesia, rest tremor, stiffnes and postural instability. These changes come from the degeneration of dopaminergic neurons. The treatment, carried out based on levodopa, provides improvements in the condition of the patients, however, they provide side effects. Based on this, the Deep Brain Stimulation (DBS) technique - stimulation of subcortical structures with electrodes - is a good treatment option. Methods: A narrative review of the literature was carried out, using the PubMed database with the keywords “Deep brain stimulation”, “Therapeutic use” and “Parkinson’s disease”. Included articles of meta-analysis, systematic review and review published in the last year. Results: The DBS offers a significant improvement in motor symptoms, gait, postural instability, reduction in tremors and in their progression. However, DBS can offer risks to the patient. Comparing the effectiveness of DBS with other therapies for Parkinson’s, such as levodopa/ carbidopa intestinal infusion gel (LCIG) and best medical therapy (BMT), it was found that BMT is botton. The cost-effectiveness comparison of these techniques, showed that DBS is the most costly procedure. It stands out comparisons can have intrinsic biases, such as the conflict of interest with pharmaceutical companies. Conclusion: DBS is a beneficial intervention for patients with PD who have important motor symptoms. Performed only in cases with indication, due to the possibility of complications.

Postural instability and falls in Parkinson’s disease

2016 ◽  
Vol 27 (5) ◽  
pp. 549-555 ◽  
Author(s):  
Jacob J. Crouse ◽  
Joseph R. Phillips ◽  
Marjan Jahanshahi ◽  
Ahmed A. Moustafa
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Fear Of Falling ◽  
Brain Regions ◽  
Postural Instability ◽  
Delayed Effect ◽  
Increased Risk ◽  
Deep Brain

AbstractPostural instability (PI) is one of the most debilitating motor symptoms of Parkinson’s disease (PD), as it is associated with an increased risk of falls and subsequent medical complications (e.g. fractures), fear of falling, decreased mobility, self-restricted physical activity, social isolation, and decreased quality of life. The pathophysiological mechanisms underlying PI in PD remain elusive. This short review provides a critical summary of the literature on PI in PD, covering the clinical features, the neural and cognitive substrates, and the effects of dopaminergic medications and deep brain stimulation. The delayed effect of dopaminergic medication combined with the success of extrastriatal deep brain stimulation suggests that PI involves neurotransmitter systems other than dopamine and brain regions extending beyond the basal ganglia, further challenging the traditional view of PD as a predominantly single-system neurodegenerative disease.

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