Abstract:
Background:It has been suggested that parkinsonian [Parkinson's disease (PD)] patients might have a "dominant" (DOM) subthalamic nucleus (STN), whose unilateral electrical stimulation [deep brain stimulation (DBS)] could lead to an improvement in PD symptoms similar to bilateral STN-DBS. Objectives:Since disability in PD patients is often related to gait problems, in this study, we wanted to investigate in a group of patients bilaterally implanted for STN-DBS: (1) if it was possible to identify a subgroup of subjects with a dominant STN; (2) in the case, if the unilateral stimulation of the dominant STN was capable to improve gait abnormalities, as assessed by instrumented multifactorial gait analysis, similarly to what observed with bilateral stimulation. Methods:We studied 10 PD patients with bilateral STN-DBS. A clinical evaluation and a kinematic, kinetic, and electromyographic (EMG) analysis of overground walking were performed-off medication-in four conditions: without stimulation, with bilateral stimulation, with unilateral right or left STN-DBS. Through a hierarchical agglomerative cluster analysis based on motor Unified Parkinson's Disease Rating Scale scores, it was possible to separate patients into two groups, based on the presence (six patients, DOM group) or absence (four patients, NDOM group) of a dominant STN. Results:In the DOM group, both bilateral and unilateral stimulation of the dominant STN significantly increased gait speed, stride length, range of motion of lower limb joints, and peaks of moment and power at the ankle joint; moreover, the EMG activation pattern of distal leg muscles was improved. The unilateral stimulation of the non-dominant STN did not produce any significant effect. In the NDOM group, only bilateral stimulation determined a significant improvement of gait parameters. Conclusion:In the DOM group, the effect of unilateral stimulation of the dominant STN determined an improvement of gait parameters similar to bilateral stimulation. The pre-surgical identification of these patients, if possible, could allow to reduce the surgical risks and side effects of DBS adopting a unilateral approach.
journal_name
Front Neuroljournal_title
Frontiers in neurologyauthors
Rizzone MG,Ferrarin M,Lanotte MM,Lopiano L,Carpinella Idoi
10.3389/fneur.2017.00575subject
Has Abstractpub_date
2017-10-30 00:00:00pages
575issn
1664-2295journal_volume
8pub_type
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abstract::Introduction: People with stroke often have impaired stepping responses following balance perturbations, which increases their risk of falling. Computer-controlled movable platforms are promising tools for delivering perturbation-based balance training under safe and standardized circumstances. Purpose: This proof-of-...
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pub_type: 杂志文章
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abstract::Multiple sclerosis (MS) and its animal model experimental autoimmune encephalomyelitis (EAE) are neurodegenerative diseases with characteristic inflammatory demyelination in the central nervous system, including the optic nerve. Neuronal and axonal damage is considered to be the main cause of long-term disability in p...
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pub_type: 杂志文章
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pub_type: 杂志文章,评审
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pub_type: 杂志文章
doi:10.3389/fneur.2018.00589
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pub_type:
doi:10.3389/fneur.2020.00963
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journal_title:Frontiers in neurology
pub_type: 杂志文章
doi:10.3389/fneur.2020.00794
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pub_type: 杂志文章
doi:10.3389/fneur.2018.01088
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pub_type: 杂志文章
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pub_type: 杂志文章,评审
doi:10.3389/fneur.2018.01001
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journal_title:Frontiers in neurology
pub_type:
doi:10.3389/fneur.2016.00130
更新日期:2016-08-10 00:00:00
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journal_title:Frontiers in neurology
pub_type: 杂志文章,评审
doi:10.3389/fneur.2020.570711
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pub_type: 杂志文章,评审
doi:10.3389/fneur.2019.00833
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pub_type: 杂志文章
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pub_type: 杂志文章,评审
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journal_title:Frontiers in neurology
pub_type:
doi:10.3389/fneur.2020.578698
更新日期:2020-10-16 00:00:00
abstract::Objectives: To assess the ability of 3D amide proton transfer weighted (APTw) imaging based on magnetization transfer analysis to discriminate between multiple sclerosis lesions (MSL) and white matter hyperintensities of presumed vascular origin (WMH) and to compare APTw signal intensity of healthy white matter (healt...
journal_title:Frontiers in neurology
pub_type: 杂志文章
doi:10.3389/fneur.2019.01307
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journal_title:Frontiers in neurology
pub_type: 杂志文章
doi:10.3389/fneur.2016.00205
更新日期:2016-11-18 00:00:00
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journal_title:Frontiers in neurology
pub_type:
doi:10.3389/fneur.2020.540911
更新日期:2020-11-05 00:00:00
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journal_title:Frontiers in neurology
pub_type: 杂志文章
doi:10.3389/fneur.2018.00374
更新日期:2018-05-28 00:00:00
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pub_type: 杂志文章
doi:10.3389/fneur.2020.618879
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pub_type:
doi:10.3389/fneur.2019.00770
更新日期:2019-07-16 00:00:00