Session Time: 1:15pm-2:45pm
Location: Les Muses Terrace, Level 3
Objective: The aim of this study is to evaluate the effect of directional steering on the gait performance in Parkinson’s disease (PD), utilizing a three-dimensional gait analysis system.
Background: Directional deep brain stimulation (DBS) leads enable current-steering in horizontal directions, which can allow stimulation to avoid side effects.
Method: We performed to evaluate 6 meters free walking and time up and go test (TUG) in PD patients who were implanted with the directional DBS leads in bilateral subthalamic nucleus. The recorded gait parameters included walking speed, stride, and walking cycle duration by three-dimensional gait analysis system utilizing a marker-less three-dimensional motion capture camera. The directions of pyramidal tract, which were identified by the directional mode screening 4weeks to 3 months before gait analysis test, was set to 0°. The gait parameters were measured in baseline, the directional steering in eight angles (0 °, 45 °, 90 °, 135 °, 180 °, 225 °, 270 °, and 315 °), the conventional ring mode with 1, 2, and 3 mA (pulse width and frequency were fixed). Placebo stimulation (0mA) were used for a control. The order of stimulation settings was randomized and both examiner and patients were blinded for the settings. Significant differences were examined using two-way analysis of variance and Tukey’s test.
Results: 11 patients were enrolled and completed the study. The mean age of the participants was 62.8 ±6.9, the male to female ratio was 8:3. For gait parameters, no significant difference was observed among directional modes, baseline, placebo, or ring mode in the 6m walking (p> 0.05). In TUG, stride had significant difference between 0 ° and other directions (p= 0.000). Stride tended to be narrower width in direction of 0 °.
Conclusion: The result of our study suggested that the stimulation using the directional steering could be an option to avoid pyramidal side effects.
To cite this abstract in AMA style:S. Sekimoto, G. Oyama, K. Bito, M. Tsuchiya, S. Kikuchi, B. Takimoto, T. Ichihashi, J. Bautista, M. Nuermaimaiti, F. Sasaki, R. Nakamura, T. Hatano, Y. Shimo, H. Iwamuro, M. Ito, A. Umemura, N. Hattori. Three-dimensional gait analysis of the effect of directional steering in Parkinson’s disease [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/three-dimensional-gait-analysis-of-the-effect-of-directional-steering-in-parkinsons-disease/. Accessed December 5, 2023.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/three-dimensional-gait-analysis-of-the-effect-of-directional-steering-in-parkinsons-disease/