Does deep brain stimulation of the nucleus ventralis intermedius affect postural control and locomotion in Parkinson's disease?

Abstract

The purpose of this study was to evaluate the effect of unilateral stimulation of the nucleus ventralis intermedius (VIM) on parkinsonian signs like postural stability and locomotion with respect to the severity of Parkinson's disease (PD). Seven patients with idiopathic PD were included in the study. Changes in visual cues on postural stability and step initiation were assessed on a fixed platform system with VIM stimulation switched either on (VIM ON) or off (VIM OFF), and compared with a control group of seven age‐matched normal individuals. Sway scores (area and path) were significantly (p <0.05) higher in the parkinsonian patients with VIM OFF than with VIM ON as well as compared with the control subjects. No correlation was obtained between extent of sway scores and severity of contralateral tremor after cessation of VIM stimulation. Locomotion parameters, by contrast, were not influenced by VIM stimulation: latency until step initiation and walking‐cycle time were the same among parkinsonian patients as among normal individuals, both in the presence and in the absence of VIM stimulation. In conclusion, our results indicate that tremor suppression by VIM stimulation improves postural stability.

Web-Based Decision Support in Selecting Patients with Parkinson's Disease for Deep Brain Stimulation

“…The underlying medical knowledge was collected from articles [2,4,[10][11][12][13][14] and its relevance concerning DBS surgery has been discussed with several medical specialists. As it turned out, not every aspect of the decision can be described clearly and some of the decision parameters still have to be evaluated.…”

Cyborgs – the Neuro‐Tech Version

“…For decades, researchers have exerted considerable effort to understand more about the disease and to find methods to successfully limit its symptoms [7], which are most commonly periodic (and frequently acute) muscle tremor and/or rigidity. Many other symptoms such as haunched stooping may however occur in later stages of PD.…”

Delayed and lasting effects of deep brain stimulation on locomotion in Parkinson's disease

“…4 The choice of stimulation target has evolved since and studies have reported positive effects of DBS on locomotion and postural stability, following stimulation of the STN, [24][25][26][27]2,14,28 SNr, 29 cortex, 30,31 thalamic Vim, 32 and zona incerta, 33 to name but a few. Today, multiple stimulations ͑e.g., STN + PPN͒ are emerging as a possibility to alleviate distal as well as axial signs.…”