Objective: To investigate the effects of deep brain stimulation (DBS) on gait and postural control in patients with Parkinson’s disease (PD) two years after surgery.

Background: The long-term effects of DBS on gait and postural control in PD is remain controversial, which may be related to the lack of follow-up investigation of objective parameters in postoperative, or to the progression of disease itself. Therefore, we used an advanced gait analyzer for testing, and the trunk range of motion during walking and posture control parameters when static standing were innovatively selected for quantitative analysis.

Method: Twenty PD patients treated with DBS were included for up to two years of follow-up. Clinical assessments included Movement Disorder Society-the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS-Ⅲ), and 39-Item Parkinson’s Disease Questionnaire (PDQ-39). A three-dimensional gait analyzer was used to record the gait and posture control parameters of the patients in 7-meter stand and walk test.

Results: 1) Compared with the preoperative medicine off period, the total score and each item of MDS-UPDRS-Ⅲ in the postoperative medicine off period/stimulator on period and postoperative medicine on/stimulator on period were decreased, and the difference was statistically significant (P <0.001). 2) The total score of PDQ-39 (P <0.001) and the sub-score of “worry about falling” (P=0.018) were significantly improved. 3)Gait and posture control parameters: compared with the preoperative medicine off period, the arm swing range(P=0.013), trunk horizontal swing range(P=0.009) and turning speed(P=0.043) of the postoperative med off period/stimulator on period were statistically significant increased, while centroid swing frequency(P=0.017) was statistically significant decreased; the arm swing speed(P=0.022)and range(P<0.001), the trunk coronal(P<0.001), sagittal(P=0.034) and horizontal(P<0.001) swing range, the turning speed(P=0.017), mean velocity(P<0.001) and the root mean square(P=0.006) of the lumbar’s trajectory were statistically significant increased during the medicine on/stimulator on period.

Conclusion: In this study, we demonstrated that DBS treatment can effectively improve the trunk range of motion and reduce the postural swing parameters. These positive changes ultimately significantly improved the patient’s postural control while walking, which in turn significantly reduced the risk of falls.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/long-term-effects-of-deep-brain-stimulation-on-gait-and-postural-control-in-parkinsons-disease/