Hausdorff J M, Cudkowicz M E, Firtion R, Wei J Y, Goldberger A L
Department of Medicine, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, Massachusetts 02215, USA.
Mov Disord. 1998 May;13(3):428-37. doi: 10.1002/mds.870130310.
The basal ganglia are thought to play an important role in regulating motor programs involved in gait and in the fluidity and sequencing of movement. We postulated that the ability to maintain a steady gait, with low stride-to-stride variability of gait cycle timing and its subphases, would be diminished with both Parkinson's disease (PD) and Huntington's disease (HD). To test this hypothesis, we obtained quantitative measures of stride-to-stride variability of gait cycle timing in subjects with PD (n = 15), HD (n = 20), and disease-free controls (n = 16). All measures of gait variability were significantly increased in PD and HD. In subjects with PD and HD, gait variability measures were two and three times that observed in control subjects, respectively. The degree of gait variability correlated with disease severity. In contrast, gait speed was significantly lower in PD, but not in HD, and average gait cycle duration and the time spent in many subphases of the gait cycle were similar in control subjects, HD subjects, and PD subjects. These findings are consistent with a differential control of gait variability, speed, and average gait cycle timing that may have implications for understanding the role of the basal ganglia in locomotor control and for quantitatively assessing gait in clinical settings.
基底神经节被认为在调节与步态以及运动的流畅性和顺序相关的运动程序中起重要作用。我们推测,帕金森病(PD)和亨廷顿舞蹈病(HD)患者保持稳定步态的能力会下降,步态周期时间及其子阶段的步幅间变异性较低。为了验证这一假设,我们对PD患者(n = 15)、HD患者(n = 20)和无病对照者(n = 16)的步态周期时间步幅间变异性进行了定量测量。PD和HD患者的所有步态变异性测量值均显著增加。在PD和HD患者中,步态变异性测量值分别是对照者的两倍和三倍。步态变异性程度与疾病严重程度相关。相比之下,PD患者的步态速度显著较低,但HD患者并非如此,对照者、HD患者和PD患者的平均步态周期持续时间以及在步态周期许多子阶段所花费的时间相似。这些发现与步态变异性、速度和平均步态周期时间的差异控制一致,这可能对理解基底神经节在运动控制中的作用以及在临床环境中定量评估步态具有重要意义。