Impact of Subthalamic Nucleus Stimulation on the Initiation of Gait in Parkinson's Disease.
From: Institute of Human Physiology I, Faculty of Medicine, University of Milan, L.A.M.B. Pierfranco & Luisa Mariani, via Mangiagalli 32, 20133 Milan, Italy. paolo.crenna@unimi.it
Experimental brain research. Experimentelle Hirnforschung. Expérimentation cérébrale
- Publish Date: Jul 2006
- ISSN: 0014-4819
- Volume: 172
- Issue: 4
- Pages: 519-32
- Medium: Print
- Language: English
- Citation (JAMA): Crenna P, Carpinella I, Rabuffetti M, et al. Impact of Subthalamic Nucleus Stimulation on the Initiation of Gait in Parkinson's Disease.. Jul 2006;172:519-32
Abstract
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.
Mesh Headings (Keywords): Aged, Analysis of Variance, Biomechanics, Deep Brain Stimulation, Electromyography, Female, Gait, Humans, Male, Middle Aged, Musculoskeletal Equilibrium, Parkinson Disease, Posture, Subthalamic Nucleus
Check for Full Text / PubMed Unique Identifier (PMID): 16555105
This abstract is part of PubMed, a service of the U.S. National Library of Medicine. PubMed includes more than 17 million citations from MEDLINE and other life science journals for biomedical articles. See Copyright and Disclaimers.
Linked medical terms appearing on this page are added by Healia to help readers find more information and are not part of the original PubMed document.
The data herein was last updated on July 8th, 2008 and may not reflect the most current and accurate data available from NLM.