Troubleshooting Gait Disturbances in Parkinson’s Disease With Deep Brain Stimulation
Open Access
- 16 May 2022
- journal article
- review article
- Published by Frontiers Media SA in Frontiers in Human Neuroscience
- Vol. 16, 806513
- https://doi.org/10.3389/fnhum.2022.806513
Abstract
Deep brain stimulation (DBS) of the subthalamic nucleus or the globus pallidus is an established treatment for Parkinson’s disease (PD) that yields a marked and lasting improvement of motor symptoms. Yet, DBS benefit on gait disturbances in PD is still debated and can be a source of dissatisfaction and poor quality of life. Gait disturbances in PD encompass a variety of clinical manifestations and rely on different pathophysiological bases. While gait disturbances arising years after DBS surgery can be related to disease progression, early impairment of gait may be secondary to treatable causes and benefits from DBS reprogramming. In this review, we tackle the issue of gait disturbances in PD patients with DBS by discussing their neurophysiological basis, providing a detailed clinical characterization, and proposing a pragmatic programming approach to support their management.Keywords
This publication has 205 references indexed in Scilit:
- Nigral stimulation for resistant axial motor impairment in Parkinson’s disease? A randomized controlled trialBrain, 2013
- Impact of sub-thalamic nucleus deep brain stimulation on dual tasking gait in Parkinson’s diseaseJournal of NeuroEngineering and Rehabilitation, 2013
- Neurostimulation for Parkinson's Disease with Early Motor ComplicationsThe New England Journal of Medicine, 2013
- Retrospective review of factors leading to dissatisfaction with subthalamic nucleus deep brain stimulation during long-term managementSurgical Neurology International, 2013
- Pattern of local field potential activity in the globus pallidus internum of dystonic patients during walking on a treadmillExperimental Neurology, 2011
- A chronic generalized bi-directional brain–machine interfaceJournal of Neural Engineering, 2011
- Knee trembling during freezing of gait represents multiple anticipatory postural adjustmentsExperimental Neurology, 2009
- The role of executive function and attention in gaitMovement Disorders, 2007
- Precise rhythmicity in activity of neocortical, thalamic and brain stem neurons in behaving cats and rabbitsBehavioural Brain Research, 2006
- What makes us tick? Functional and neural mechanisms of interval timingNature Reviews Neuroscience, 2005