Evaluating gait and postural responses to subthalamic stimulation and levodopa: A prospective study using wearable technology

IF 4.5 2区医学 Q1 CLINICAL NEUROLOGY

European Journal of Neurology Pub Date : 2024-12-19 DOI:10.1111/ene.16580

Ilaria Cani, Ilaria D'Ascanio, Luca Baldelli, Giovanna Lopane, Saverio Ranciati, Paolo Mantovani, Alfredo Conti, Pietro Cortelli, Giovanna Calandra-Buonaura, Lorenzo Chiari, Luca Palmerini, Giulia Giannini

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引用次数: 0

Abstract

Background

The efficacy of subthalamic stimulation on axial signs of Parkinson's disease (PD) is debated in the literature. This study delves into the dynamic interplay of gait and posture, specifically probing their nuanced response to subthalamic stimulation and levodopa.

Methods

We used wearable sensor technology to examine alterations in the spatiotemporal parameters of gait and posture in individuals with PD before and 6 months after subthalamic deep brain stimulation (STN-DBS) surgery. Thirty-three subjects with PD were evaluated in two pre-operative and four post-operative conditions comprising OFF/ON medication and stimulation states. Standardized response mean (SRM) values were calculated to assess treatment responsiveness.

Results

Significant improvements in spatiotemporal gait parameters, including speed, stride length, cadence, and turning, were observed following STN-DBS surgery. Quantitatively, stimulation outperformed levodopa in enhancing gait speed, stride length, and turning, as indicated by SRM. Levodopa moderately improved stride time variability and asymmetry, while stimulation alone demonstrated limited efficacy. Postural parameters exhibited minimal change following STN-DBS, although stimulation showed a slight benefit in certain postural aspects.

Conclusion

Our findings suggest positive effects of stimulation and levodopa on gait and postural parameters, with STN-DBS demonstrating superior efficacy in enhancing gait speed, stride length, and turning. However, gait variability remains unaddressed by current therapies, highlighting the need for novel treatments targeting regions beyond the basal ganglia.

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来源期刊

European Journal of Neurology 医学-临床神经学

CiteScore

9.70

自引率

2.00%

发文量

418

审稿时长

1 months

期刊介绍： The European Journal of Neurology is the official journal of the European Academy of Neurology and covers all areas of clinical and basic research in neurology, including pre-clinical research of immediate translational value for new potential treatments. Emphasis is placed on major diseases of large clinical and socio-economic importance (dementia, stroke, epilepsy, headache, multiple sclerosis, movement disorders, and infectious diseases).