May David S, van Dillen Linda R, Earhart Gammon M, Rawson Kerri S, Perlmutter Joel S, Duncan Ryan P
Program in Physical Therapy, Washington University in St. Louis, St. Louis, MO 63108-2212, USA.
Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO 63130, USA.
Brain Sci. 2020 Sep 30;10(10):693. doi: 10.3390/brainsci10100693.
Subthalamic nucleus deep brain stimulation (STN-DBS) and levodopa are common treatment strategies for Parkinson's disease (PD). However, the specific effects of these treatment strategies on balance and its components remain unclear. This cross-sectional study of people with PD and STN-DBS compared balance in the treated state (ON-medication/ON-stimulation) and untreated state (OFF-medication/OFF-stimulation) using the Balance Evaluation Systems Test (BESTest). Total BESTest scores from the treated and untreated states were compared to assess overall balance. Scores for the six sections of the BESTest were further compared to assess differences in specific components of balance between treatment conditions. Twenty-nine participants were included (Male: 21, Female: 8, Mean Age ± SD: 65.0 ± 6.9). Total BESTest scores showed improved balance in the treated state compared to the untreated state (Treated: 67.56 ± 10.92; Untreated: 59.23 ± 16.51, < 0.001). Four sections (Stability Limits/Verticality, Anticipatory Postural Reactions, Sensory Orientation, Stability in Gait) of the BESTest significantly improved in the treated state relative to the untreated state, after correcting for multiple comparisons ( < 0.05). These results demonstrate that STN-DBS and levodopa improve overall balance and provide a first step toward understanding the effects of these treatment strategies on specific components of balance.
丘脑底核深部脑刺激（STN-DBS）和左旋多巴是帕金森病（PD）的常见治疗策略。然而，这些治疗策略对平衡及其组成部分的具体影响仍不清楚。这项针对帕金森病患者和接受STN-DBS治疗患者的横断面研究，使用平衡评估系统测试（BESTest）比较了治疗状态（服药/刺激开启）和未治疗状态（停药/刺激关闭）下的平衡情况。比较了治疗状态和未治疗状态下的BESTest总分，以评估整体平衡。进一步比较了BESTest六个部分的得分，以评估不同治疗条件下平衡特定组成部分的差异。纳入了29名参与者（男性：21名，女性：8名，平均年龄±标准差：65.0±6.9）。与未治疗状态相比，治疗状态下的BESTest总分显示平衡得到改善（治疗状态：67.56±10.92；未治疗状态：59.23±16.51，<0.001）。在进行多重比较校正后，BESTest的四个部分（稳定极限/垂直度、预期姿势反应、感觉定向、步态稳定性）在治疗状态下相对于未治疗状态有显著改善（<0.05）。这些结果表明，STN-DBS和左旋多巴可改善整体平衡，并为理解这些治疗策略对平衡特定组成部分的影响迈出了第一步。
