Session Information
Date: Monday, June 20, 2016
Session Title: Surgical therapy: Parkinson's disease
Session Time: 12:30pm-2:00pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To identify the effects of subthalamic nucleus deep brain stimulation on gait kinematics in patients with PD and describe the incidence of gait dysfunction after STN DBS.
Background: STN-DBS improves motor scores and mobility in PD patients, however worsening of axial symptoms- predominantly gait – has been described in some cases. The cause of gait worsening is unknown, but it has been proposed that overstimulation or perhaps asymmetric STN stimulation may produce freezing of gait (FOG) inspite of improvement in motor scores.
Methods: 30 patients that underwent STN-DBS were assessed for gait dysfunction 6-12 months after the surgery. Gait kinematics were measured using wireless sensors (APDM Inc). MDS-UPDRS was performed pre and post DBS.
Results: Mean age of PD patients was 62.1 years (+/-10), with an average disease duration of 10.2 years (+/-3.4). Bilateral STN stimulation improved MDS-UPDRS motor score with 55.7% (41.5 +/-10.4 OFF DBS, 18.8 +/-7.5 ON DBS, p < 0.005), and patients were able to reduce the levodopa from 812 mg to 374 mg. Mean velocity after DBS was 1.05 m/s(+/- 0.19) and stride length 1.21 m(+/-0.2). The mean turn time was 3.27s(+/-1) with an average of 6 steps during turn. Patients had high gait variability 0.08(+/-0.04) and increased double limb support 25.5% (+/- 7). In this cohort of 30 patients, 4 complained of worsening gait after DBS inspite of improvement in the motor scores. The velocity was 0.74 m/s with a stride of 0.94 m, turning time of 4.5 seconds and 8 steps per turn. They had greater gait variability (0.11) and higher double limb support 37.4%. Reprogramming of the device with lower frequency improved walking .
Conclusions: STN DBS improves motor scores and gait in PD patients. A minority of patients may experience worsening gait after DBS and reprogramming should be performed with special focus on FOG. Larger studies are necessary to identify the factors associated with increased risks of gait dysfunction after STN-DBS.
To cite this abstract in AMA style:
V. Velez-Aldahondo, A.B. Millard, J.R. Jagid, C.C. Luca. Incidence and characteristics of gait dysfunction after subthalamic nucleus deep brain stimulation [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/incidence-and-characteristics-of-gait-dysfunction-after-subthalamic-nucleus-deep-brain-stimulation/. Accessed June 14, 2025.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/incidence-and-characteristics-of-gait-dysfunction-after-subthalamic-nucleus-deep-brain-stimulation/