Lateralized Subthalamic Stimulation for Axial Dysfunction in Parkinson's Disease: A Randomized Trial.
Parkinson's disease
asymmetry
axial motor function
deep brain stimulation
lateralization
Journal
Movement disorders : official journal of the Movement Disorder Society
ISSN: 1531-8257
Titre abrégé: Mov Disord
Pays: United States
ID NLM: 8610688
Informations de publication
Date de publication:
05 2022
05 2022
Historique:
revised:
18
01
2022
received:
30
06
2021
accepted:
20
01
2022
pubmed:
15
2
2022
medline:
24
5
2022
entrez:
14
2
2022
Statut:
ppublish
Résumé
Patients with Parkinson's disease might develop treatment-resistant axial dysfunction after bilateral subthalamic stimulation. To study whether lateralized stimulation (unilateral 50% amplitude reduction) for ≥21 days results in ≥0.13 m/s faster gait velocity in the dopaminergic ON state in these patients, and its effects on motor and axial function, quantitative gait and speech measures, quality of life, and selected cognitive tasks. Randomized, double-blinded, double-crossover trial. In 22 participants (51-79 years old, 15 women), there were no significant changes in gait velocity, quality of life, cognitive, and speech measures. Reducing left-sided amplitude resulted in a 2.5-point improvement in axial motor Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) (P = 0.005, uncorrected) and a 1.9-point improvement in the Freezing of Gait Questionnaire (P = 0.024, uncorrected). Lateralized subthalamic stimulation does not result in meaningful improvement in gait velocity in patients with Parkinson's disease who develop treatment-resistant axial dysfunction after bilateral subthalamic stimulation. Left subthalamic overstimulation may contribute to axial deterioration in these patients. © 2022 International Parkinson and Movement Disorder Society.
Sections du résumé
BACKGROUND
Patients with Parkinson's disease might develop treatment-resistant axial dysfunction after bilateral subthalamic stimulation.
OBJECTIVES
To study whether lateralized stimulation (unilateral 50% amplitude reduction) for ≥21 days results in ≥0.13 m/s faster gait velocity in the dopaminergic ON state in these patients, and its effects on motor and axial function, quantitative gait and speech measures, quality of life, and selected cognitive tasks.
METHODS
Randomized, double-blinded, double-crossover trial.
RESULTS
In 22 participants (51-79 years old, 15 women), there were no significant changes in gait velocity, quality of life, cognitive, and speech measures. Reducing left-sided amplitude resulted in a 2.5-point improvement in axial motor Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) (P = 0.005, uncorrected) and a 1.9-point improvement in the Freezing of Gait Questionnaire (P = 0.024, uncorrected).
CONCLUSIONS
Lateralized subthalamic stimulation does not result in meaningful improvement in gait velocity in patients with Parkinson's disease who develop treatment-resistant axial dysfunction after bilateral subthalamic stimulation. Left subthalamic overstimulation may contribute to axial deterioration in these patients. © 2022 International Parkinson and Movement Disorder Society.
Banques de données
ClinicalTrials.gov
['NCT03462082']
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1079-1087Subventions
Organisme : NINDS NIH HHS
ID : R25 NS088248
Pays : United States
Organisme : NINDS NIH HHS
ID : R25 NS098999
Pays : United States
Informations de copyright
© 2022 International Parkinson and Movement Disorder Society.
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