Objective: Objectivisation of degree of postural disorders in PD patients during the screening stage for DBS.

Background: The neurosurgical treatment of Parkinson’s disease (PD) using the deep brain stimulation (DBS) actively applied in Belarus since 2011. Efficacy of this treatment depends largely on the careful selection of patients considering the indications and contraindications. It is known that postural instability (from moderate to severe) is one of the contraindications, which not only responds poorly to therapeutic correction, but also can be exacerbated on a background of DBS.

Methods: 44 patients with PD was examined for the screening for surgical treatment since 2014 to 2015. Including 20 women and 24 men with a mean age (49,2±10,6 years). There are 26 patients with II st. of Hoehn and Yahr scale, 18 patients with III st. At the moment of examination 26 patients with II st. didn’t complain of falling, instability and postural instability has not been determined by clinical examination. 26 patients with II st. were examined in ON-period on computer stabiloanalizator "Stabilan-01-2" with biofeedback (produced by "Rhythm", Russia). The objective of the test was to hold the moving marker by deviation of the body. The results are presented as a diagram deployed in the directions of testing and indicators of statokineziogramm. Stability parameters were assessed: the scatter in the frontal plane (SF,mm) the scatter in the sagittal plane (SS,mm), the average speed of movement of the center of pressure (ASMCP,mm/s), ellipse area (EA,mm2). Postural disorders are diagnosed when magnitudes of all the values of the SF, SS, ASMCP, EA in test are increased less than 35% of the same indicators in the Romberg Test (RT).

Results: Stabilometry with biofeedback has revealed a decrease in deviation of the central pressure in 9 (34,6%) out of 26 patients: on the frontal plane – 2, on the sagittal – 7 patients. The values ASMCP amounted 4,94±2,1 mm/s, EA 187,72±41,9 mm2 compared with similar indicators in the RT 4,12±1,9 mm/s and 144.4±51,9 mm2 (p<0,05). The percent increase in values of indicators of statokineziogramm was only 20±14,9%.

Conclusions: Stabilometry with biofeedback allowed objectify postural instability in 34.6% of patients with PD II st. in the form of limitation of voluntary control of posture and determine contraindications for DBS.

« Back to 2016 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/objectivisation-of-postural-disorders-in-patients-with-parkinsons-disease-during-the-screening-stage-for-dbs/