The effects of brain stimulation of subthalamic nucleus surgery on gait and balance performance in Parkinson disease. A pilot study

Abstract

A b s t r a c t I In nt tr ro od du uc ct ti io on n: : Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by tremor, rigidity and bradykinesia. Gait and postural difficulties supersede tremor, rigidity and bradykinesia as drivers of disease burden in patients with advanced PD. The aim of this study was to describe the effects of deep brain stimulation of the subthalamic nucleus on gait ability and balance performance in patients with PD. M Ma at te er ri ia al l a an nd d m me et th ho od ds s: : We studied 19 consecutive patients who underwent bilateral stimulation of the subthalamic nucleus. Patients were evaluated preoperatively and at the 5 th day and 6 th month after surgery. Timed Up and Go Test, 12 m Walking Test, Chair Stand Test and Berg Balance Scale (BBS) were used to assess mobility and balance performance. Unified Parkinson's Disease Rating Scale (UPDRS III) and Hoehn and Yahr Scale were also used. R Re es su ul lt ts s: : All the patients' mobility ability and balance performance improved after surgery (p < 0.05). At the 6 th month after surgery, the Timed Up and Go Test scores were decreased from 56.05 ±42.52 to 21.47 ±20.36, the 12 m Walking Test scores were decreased from 100.44 ±66.44 to 28.84 ±19.79, the Chair Stand Test scores were increased from 4.00 ±4.66 to 11.68 ±4.43 and the BBS score was increased from 12.84 ±6.89 to 38.89 ±8.79. UPDRS total scores were significantly improved 6 months after surgery (p < 0.001). UPDRS total scores were decreased from 98.26 ±37.69 to 39.36 ±18.85. The Hoehn and Yahr Scale score was significantly decreased after surgery (p < 0.05). C Co on nc cl lu us si io on ns s: : Surgical therapy is an effective treatment to improve gait ability and balance performance in Parkinson's patients. K Ke ey y w wo or rd ds s: : Parkinson's disease, balance performance, gait ability, subthalamic nucleus.

Impact of the Secretome of Human Mesenchymal Stem Cells on Brain Structure and Animal Behavior in a Rat Model of Parkinson's Disease

“…However, despite these pharmacological advances, most of these treatments have been shown to be insufficient, presenting some undesirable side effects, long‐term inefficiency, and the inability to recover lost DA neurons or to protect the viability of the remaining ones . Surgical treatments, such as deep‐brain stimulation, have been applied as an alternative in patients in whom pharmacological treatment is no longer effective , , . However, as with drug treatments, the apparent clinical recovery after surgery does not last and the progression of the degenerative process is not avoided , .…”