Artikel
Synergistic effect of chronic bilateral subthalamic nucleus stimulation and medication in advanced Parkinson’s Disease: computerized gait analysis at 3 months and 1 year postoperatively
Synergistischer Effekt der bilateralen Tiefenhirnstimulation im Nukleus Subthalamicus und der Medikation bei fortgeschrittener Parkinsonerkrankung: Ergebnisse der computerisierten Ganganalyse nach 3 Monaten und einem Jahr postoperativ
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Autoren
Veröffentlicht: | 4. Mai 2005 |
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Gliederung
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Objective
Computerized gait analysis was used to study prospectively the long term-term effects of both chronic bilateral subthalamic nucleus (STN) stimulation and medication with levodopa on gait in patients with advanced idiopathic Parkinson’s disease.
Methods
Eight patients with advanced Parkinson’s disease (3 women, 5 men, mean age 68.5 ys) underwent bilateral STN-stimulation. Instrumental gait analysis was performed using a computer-assisted gait analyzing system (Ultraflex, Infotronic, The Netherlands). The preoperative and postoperative (3 and 12 months after surgery) spatial and temporal gait parameters were analyzed in off-drug and on-drug conditions.
Results
In the medication-off condition, objective gait scores were improved with bilateral STN-stimulation both at the 3-month and the 12-month follow-up. Preoperative gait measurements during best medication-on states were also improved with bilateral STN-stimulation as demonstrated in the follow-up assessments. Net medication effects at 3 and 12 months after operation were equivalent to net stimulation effects.
Conclusions
Bilateral STN-stimulation resulted in a substantial improvement of gait parameteres in our cohort of elderly patients with advanced Parkinson’s disease. Net medication effects were equivalent to net stimulation effects, but the combination of both led to further improvement.