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Effect of subthalamic deep brain stimulation on posture in Parkinson's disease: A blind computerized analysis.

Abstract：

INTRODUCTION:We sought to assess the effect of subthalamic deep brain stimulation (STN DBS) on Parkinson's disease (PD)-associated postural abnormalities. METHODS:A computerized analysis of posture was used to quantify the thoracolumbar, thoracic, and cervical-occipital ventral angles, as well as the thoracolumbar and cervical-occipital lateral angles from the video-repository of three specialized movement disorder centers (n = 158 patients). Data was extracted from frames from video-recordings in the pre-surgical medication-ON (dopaminergic therapy) and post-surgical stimulation-ON/medication-ON states (STN DBS plus dopaminergic therapy). The sum of the five postural angles (global postural angle) was used to compare pre-vs. post-surgical trunk posture alterations. A multivariate analysis was used to examine the association between changes in the postural angles and demographic or clinical variables. RESULTS:There was a 6.7% amelioration in the global postural angle between the pre- and post-surgical assessments (p = 0.031). Motor response to and pre-surgical dosage of levodopa, male gender, and shorter PD duration were identified as predictors for posture improvement after STN DBS. Cases meeting criteria for lower (n = 2) or upper (n = 1) camptocormia respectively improved by 48.1% in the ventral thoracolumbar angle (from 36.4 ± 0.0° to 18.9 ± 4.2°) and 13.8% in the ventral thoracic angle (from 49.1° to 42.3°). Cases meeting criteria for Pisa syndrome (n = 2) improved by 67.5% in the lateral thoracolumbar angle (from 16.9 ± 2.0° to 5.5 ± 4.7°). CONCLUSIONS:STN DBS has a relatively small but significant effect on PD-associated postural abnormalities, potentially enhancing the effect of dopaminergic medications alone.

journal_name

Parkinsonism Relat Disord

journal_title

Parkinsonism & related disorders

authors

Roediger J,Artusi CA,Romagnolo A,Boyne P,Zibetti M,Lopiano L,Espay AJ,Fasano A,Merola A

doi

10.1016/j.parkreldis.2019.01.003

subject

Has Abstract

pub_date

2019-05-01 00:00:00

pages

122-127

eissn

1353-8020

issn

1873-5126

pii

S1353-8020(19)30003-3

journal_volume

62

pub_type

杂志文章

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