Seger, Aline, Gulberti, Alessandro, Vettorazzi, Eik, Braa, Hanna, Buhmann, Carsten, Gerloff, Christian, Hamel, Wolfgang, Moll, Christian K. E. and Poetter-Nerger, Monika (2021). Short Pulse and Conventional Deep Brain Stimulation Equally Improve the Parkinsonian Gait Disorder. J. Parkinsons Dis., 11 (3). S. 1455 - 1465. AMSTERDAM: IOS PRESS. ISSN 1877-718X

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Abstract

Background: Gait disturbances and balance remain challenging issues in Parkinsonian patients (PD) with deep brain stimulation (DBS). Short pulse deep brain stimulation (spDBS) increases the therapeutic window in PD patients, yet the effect on gait and postural symptoms remains unknown. Objective: We assessed the efficacy of spDBS compared to conventional DBS (cDBS) within the subthalamic nucleus (STN) on Parkinsonian gait. Methods: The study was a single-centre, randomized, double-blind, clinical short-term trial. 20 PD patients were studied postoperatively in three different conditions (DBS stimulation switched off (off DBS), spDBS with 40 mu s pulse width, cDBS with 60 mu s pulse width) on regular medication. The primary endpoint was the relative difference of gait velocity at selfpaced speed during quantitative gait analysis between stimulation conditions. Secondary endpoints were changes of further measures of quantitative gait analysis, Ziegler course, Berg balance scale, FOG questionnaire, MDS-UPDRS, PDQ-39, and HADS. Mixed-model analysis and post-hoc t-tests were performed. Results: Both spDBS and cDBS improved gait velocity at self-paced speed compared to off DBS, however, there was no significant difference between both stimulation modes. Still, 40% of the patients preferred spDBS over cDBS subjectively. Both stimulation modes were equally effective in improving secondary endpoints of gait, balance, motor and non-motor performances. Conclusion: The use of spDBS and cDBS is equally effective in improving gait and balance in PD and might be beneficial in specified cohorts of PD patients.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Seger, AlineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gulberti, AlessandroUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vettorazzi, EikUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Braa, HannaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Buhmann, CarstenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gerloff, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hamel, WolfgangUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Moll, Christian K. E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Poetter-Nerger, MonikaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-580692
DOI: 10.3233/JPD-202492
Journal or Publication Title: J. Parkinsons Dis.
Volume: 11
Number: 3
Page Range: S. 1455 - 1465
Date: 2021
Publisher: IOS PRESS
Place of Publication: AMSTERDAM
ISSN: 1877-718X
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
SUBTHALAMIC STIMULATION; DISEASE; WIDTH; NUCLEUS; BALANCE; SCALEMultiple languages
NeurosciencesMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/58069

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