Tel-Aviv Sourasky Medical Center, Israel.
Mov Disord. 2009 Aug 15;24(11):1688-92. doi: 10.1002/mds.22554.
The effects of subthalamic nucleus (STN) deep brain stimulation (DBS) on fall risk in patients with Parkinson's disease (PD) currently remain unclear. Although several gait parameters, such as gait speed, have shown improvement with DBS, some studies have reported an increased fall risk following DBS. The purpose of this study was to examine the effect of bilateral DBS on gait variability, a marker of fall risk. The gait of 13 patients with idiopathic PD was analyzed to determine the influence of DBS, levodopa and both therapies together. Following treatment with both levodopa and STN DBS, subjects displayed improved gait speed, reduced gait variability (enhanced stability), and lower Unified Parkinson's Disease Rating Scale (UPDRS) scores. Although UPDRS scores improved with STN DBS alone, parallel improvements were not seen for gait variability. These findings suggest that different mechanisms may contribute to performance on UPDRS motor testing and gait stability in response to DBS.
丘脑底核（STN）深部脑刺激（DBS）对帕金森病（PD）患者跌倒风险的影响目前尚不清楚。尽管 DBS 可改善几项步态参数，如步态速度，但一些研究报告 DBS 后跌倒风险增加。本研究旨在探讨双侧 DBS 对跌倒风险标志物——步态变异性的影响。分析了 13 例特发性 PD 患者的步态，以确定 DBS、左旋多巴和两种治疗方法的综合影响。在接受左旋多巴和 STN-DBS 联合治疗后，患者的步态速度提高，步态变异性降低（稳定性增强），帕金森病评定量表（UPDRS）评分降低。虽然单独进行 STN-DBS 治疗可改善 UPDRS 评分，但步态变异性未见平行改善。这些发现表明，不同的机制可能有助于 DBS 治疗对 UPDRS 运动测试和步态稳定性的影响。
