Vpliv zdravljenja z globoko možgansko stimulacijo na hojo in držo bolnikov s Parkinsonovo boleznijo
The effects of deep brain stimulation on gait and posture in Parkinson’s disease patients

slovenian

2023

volume 62, issue 1

gait   Parkinson’s disease   standing

Društvo Medicinski razgledi
(Obvezni izvod spletne publikacije)

Deep brain stimulation of subthalamic nuclei is a contemporary method for treating advanced Parkinson’s disease. Mechanisms of deep brain stimulation (DBS) are not entirely clear, but the influence of DBS on the cortico-striatal-thalamic-cortical loop greatly alleviates disease symptoms. There are clear positive effects on akinesia, rigidity, and tremor, but some patients experience the deterioration of gait. DBS improves some parameters of gait and posture in Parkinson’s disease. In a quiet standing position, it reduces the exaggerated tilt of torso, thighs, and calves, which appear because of increased flexor activity. The effect of DBS on center of pressure displacement is still unclear, with studies describing both reduction and increase during quiet standing. DBS improves posture control during tests with limited or incongruous visual or somatosensory input, and adaptive responses to perturbations are improved. The effect of DBS on anticipatory postural adjustments during gait initiation and posture control during gait are still unclear. The length and velocity of the first step are increased, balance during the first step is also improved. DBS impro- ves gait parameters with increased step length, velocity, leg flexibility, reduced double support phase and normalization of leg muscle activation. Step asymmetry and variability is reduced, and limbs are better coordinated. All this enables a more physiologic gait. This short review article describes the basic features of physiologic gait, gait changes in Parkinson’s disease, and the effects of DBS on standing and gait parameters.

01.07.2023