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Tytuł:
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Physiological measures and anatomical correlates of subthalamic deep brain stimulation effect on gait in Parkinson's disease.
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Autorzy:
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Agharazi H; Louis Stokes Cleveland VA Medical Center, Cleveland, OH, United States of America.
Hardin EC; Louis Stokes Cleveland VA Medical Center, Cleveland, OH, United States of America; Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States of America.
Flannery K; Louis Stokes Cleveland VA Medical Center, Cleveland, OH, United States of America.
Beylergil SB; Louis Stokes Cleveland VA Medical Center, Cleveland, OH, United States of America.
Noecker A; Department of Biomedical Engineering, Duke University, Durham, NC, United States of America.
Kilbane C; Neurological Institute, University Hospitals, Cleveland, OH, United States of America; Department of Neurology, Case Western Reserve University, Cleveland, OH, United States of America.
Factor SA; Jean and Paul Amos Parkinson's Disease and Movement Disorder Program, Department of Neurology, Emory University, Atlanta, GA, United States of America.
McIntyre C; Department of Biomedical Engineering, Duke University, Durham, NC, United States of America.
Shaikh AG; Louis Stokes Cleveland VA Medical Center, Cleveland, OH, United States of America; Neurological Institute, University Hospitals, Cleveland, OH, United States of America; Department of Neurology, Case Western Reserve University, Cleveland, OH, United States of America; Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States of America. Electronic address: .
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Źródło:
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Journal of the neurological sciences [J Neurol Sci] 2023 Jun 15; Vol. 449, pp. 120647. Date of Electronic Publication: 2023 Apr 11.
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Typ publikacji:
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Journal Article; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Original Publication: Amsterdam : Elsevier, <19 ->
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MeSH Terms:
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Parkinson Disease*/complications
Parkinson Disease*/therapy
Deep Brain Stimulation*/methods
Subthalamic Nucleus*/physiology
Humans ; Gait/physiology ; Walking
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Contributed Indexing:
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Keywords: Deep brain stimulation; Falls; Gait; Parkinson's disease
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Entry Date(s):
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Date Created: 20230426 Date Completed: 20230516 Latest Revision: 20230516
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Update Code:
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20240105
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DOI:
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10.1016/j.jns.2023.120647
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PMID:
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37100017
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We examined whether conflicting visual and non-visual information leads to gait abnormalities and how the subthalamic deep brain stimulation (STN DBS) influences gait dysfunction in Parkinson's disease (PD). We used a motion capture system to measure the kinematics of the lower limbs during treadmill walking in immersive virtual reality. The visual information provided in the virtual reality paradigm was modulated to create a mismatch between the optic-flow velocity of the visual scene and the walking speed on the treadmill. In each mismatched condition, we calculated the step duration, step length, step phase, step height, and asymmetries. The key finding of our study was that mismatch between treadmill walking speed and the optic-flow velocity did not consistently alter gait parameters in PD. We also found that STN DBS improved the PD gait pattern by changing the stride length and step height. The effects on phase and left/right asymmetry were not statistically significant. The DBS parameters and location also determined its effects on gait. Statistical effects on stride length and step height were noted when the DBS volume of activated tissue (VTA) was in the dorsal aspect of the subthalamus. The statistically significant effects of STN DBS was present when VTA significantly overlapped with MR tractogrphically measured motor and pre-motor hyperdirect pathways. In summary, our results provide novel insight into ways for controlling walking behavior in PD using STN DBS.
(Copyright © 2023 Elsevier B.V. All rights reserved.)
