Sako Wataru
Department of Clinical Neuroscience, Institute of Health Biosciences, Tokushima University, Graduate School of Medical Sciences, Tokushima, Japan.
Brain Nerve. 2010 Nov;62(11):1221-5.
Gait disturbance, one of the axial symptoms, is caused by various disorders, including basal ganglia disease. Deep brain stimulation (DBS) has widened the spectrum of therapeutic options for patients with gait disturbance due to Parkinson disease and dystonia. In gait disturbance caused by basal ganglia disease, the main targets of DBS are the subthalamic nucleus (STN) and globus pallidus internus (GPi). STN DBS is more than GPi DBS effective for treating levodopa-responsive parkinsonian symptoms, including gait disturbance. GPi DBS is effective for the treatment of primary segmental or generalized dystonia. The pedunculopontine tegmental nucleus (PPN), which is involved in locomotion, is one of the new targets for treating gait disturbance in Parkinson disease. We review DBS in the treatment of gait disturbance due to Parkinson disease and dystonia.
步态障碍是轴性症状之一,由多种疾病引起,包括基底节疾病。深部脑刺激(DBS)拓宽了帕金森病和肌张力障碍所致步态障碍患者的治疗选择范围。在基底节疾病引起的步态障碍中,DBS的主要靶点是丘脑底核(STN)和苍白球内侧部(GPi)。STN DBS在治疗包括步态障碍在内的左旋多巴反应性帕金森症状方面比GPi DBS更有效。GPi DBS对原发性节段性或全身性肌张力障碍有效。参与运动的脚桥被盖核(PPN)是治疗帕金森病步态障碍的新靶点之一。我们综述了DBS在治疗帕金森病和肌张力障碍所致步态障碍中的应用。