Bonnet Cédrick T, Delval Arnaud, Szaffarczyk Sébastien, Defebvre Luc
SCALab, CNRS UMR 9193, Faculté de médecine, pôle recherche, 5(e) étage ouest, Université de Lille, F-59000 Lille, France.
Service de neurophysiologie clinique, Hôpital Salengro, CHRU, F-59000 Lille, France; Unité INSERM 1171, Faculté de médecine, Université de Lille, F-59000 Lille, France.
Behav Brain Res. 2017 Jul 28;331:67-75. doi: 10.1016/j.bbr.2017.05.033. Epub 2017 May 16.
Patients with Parkinson's disease have better functional status and motor performance under on-drug conditions. However, the administration of levodopa leads to greater postural sway. The present study's primary objective was to determine whether this on-drug problem may be related to a lack of adjustment in postural control mechanisms and body segment rotations. Fourteen patients with Parkinson's disease and 14 controls performed two gaze-shift tasks (40° to the left and 40° to the right, at 0.125 and 0.25Hz) and a stationary gaze task in two sessions (an off-drug session and an on-drug session for the patients, and two off-drug sessions for the controls). At baseline, the "on-drug" patients indeed swayed significantly more than the controls during the gaze-shift tasks. As expected, acute L-dopa administration did not increase eye, head, neck and lower back rotation of the patients during the gaze-shift tasks. Unexpectedly, levodopa appeared to enable the patients to significantly increase the contribution of their postural control mechanisms (relative to controls) during the gaze-shift tasks. However, and as expected, this adjustment was not great enough to enable the patients to maintain their postural sway as well as the controls did. Overall, the administration of levodopa seemed to destabilize the patients - especially with regard to the lower back region. In addition, the patients used hypermetric eye rotations during the gaze-shift tasks under both off- and on-drug conditions. If they had not used these compensatory eye rotations, their unsafe behavior at the hip level might have been even more pronounced. Future research should focus on this lower back weakness.
帕金森病患者在服药状态下具有更好的功能状态和运动表现。然而，左旋多巴的给药会导致更大的姿势摆动。本研究的主要目的是确定这种服药后的问题是否可能与姿势控制机制和身体节段旋转缺乏调整有关。14名帕金森病患者和14名对照者进行了两项注视转移任务（向左和向右各40°，频率分别为0.125Hz和0.25Hz）以及一项固定注视任务，分两个阶段进行（患者的停药阶段和服药阶段，对照者的两个停药阶段）。在基线时，“服药”的患者在注视转移任务期间的摆动确实比对照者明显更多。正如预期的那样，急性给予左旋多巴并没有增加患者在注视转移任务期间眼睛、头部、颈部和下背部的旋转。出乎意料的是，左旋多巴似乎使患者在注视转移任务期间能够显著增加其姿势控制机制的贡献（相对于对照者）。然而，正如预期的那样，这种调整还不足以使患者像对照者那样保持姿势摆动。总体而言，左旋多巴的给药似乎使患者的姿势不稳定——尤其是在下背部区域。此外，患者在停药和服药状态下的注视转移任务中都使用了过度的眼球旋转。如果他们没有使用这些代偿性眼球旋转，他们在髋部水平的不安全行为可能会更加明显。未来的研究应关注这种下背部的虚弱。
