Postural instability and gait disorders after subthalamic nucleus deep brain stimulation in Parkinson’s disease: a PET study View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-07-26

AUTHORS

Kévin Ahrweiller, J. F. Houvenaghel, A. Riou, S. Drapier, P. Sauleau, C. Haegelen, P. Jannin, M. Vérin, X. Palard, F. Le Jeune

ABSTRACT

IntroductionPatients with Parkinson’s disease sometimes report postural instability and gait disorders (PIGD) after subthalamic nucleus deep brain stimulation (STN-DBS). Whether this is the direct consequence of DBS or the result of natural disease progression is still subject to debate.ObjectiveTo compare changes in brain metabolism during STN-DBS between patients with and without PIGD after surgery.MethodsWe extracted consecutive patients from a database where all Rennes Hospital patients undergoing STN-DBS are registered, with regular prospective updates of their clinical data. Patients were divided into two groups (PIGD and No PIGD) according to changes after surgery, as measured with a composite score based on the selected Unified Parkinson’s Disease Rating Scale items. All patients underwent positron emission tomography with 18[F]-fluorodeoxyglucose 3 months before and after surgery. We ran an ANOVA with two factors (group: PIGD vs. No PIGD; and phase: preoperative vs. postoperative) on SPM8 to compare changes in brain metabolism between the two groups.ResultsParticipants were 56 patients, including 10 in the PIGD group. The two groups had similar baseline (i.e., before surgery) characteristics. We found two clusters of increased metabolism in the PIGD group relative to the No PIGD group: dorsal midbrain/pons, including locomotor mesencephalic region and reticular pontine formation, and right motor cerebellum.ConclusionWe found different metabolic changes during DBS-STN among patients with PIGD, concerning brain regions that are already known to be involved in gait disorders in Parkinson’s disease, suggesting that DBS is responsible for the appearance of PIGD. More... »

PAGES

2764-2771

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00415-019-09482-y

DOI

http://dx.doi.org/10.1007/s00415-019-09482-y

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1119865109

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/31350641


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