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Compensatory stepping in Parkinson's disease is still a problem after deep brain stimulation randomized to STN or GPi


St George, RJ and Carlson-Kuhta, P and King, LA and Burchiel, KJ and Horak, FB, Compensatory stepping in Parkinson's disease is still a problem after deep brain stimulation randomized to STN or GPi, Journal of Neurophysiology, 114, (3) pp. 1417-1423. ISSN 0022-3077 (2015) [Refereed Article]

Copyright Statement

Copyright 2015 American Physiological Society

DOI: doi:10.1152/jn.01052.2014


The effects of deep brain stimulation (DBS) on balance in people with Parkinson's disease (PD) are not well established. This study examined whether DBS randomized to the subthalamic nucleus (STN; n = 11) or globus pallidus interna (GPi; n = 10) improved compensatory stepping to recover balance after a perturbation. The standing surface translated backward, forcing subjects to take compensatory steps forward. Kinematic and kinetic responses were recorded. PD-DBS subjects were tested off and on their levodopa medication before bilateral DBS surgery and retested 6 mo later off and on DBS, combined with off and on levodopa medication. Responses were compared with PD-control subjects (n = 8) tested over the same timescale and 17 healthy control subjects. Neither DBS nor levodopa improved the stepping response. Compensatory stepping in the best-treated state after surgery (DBS+DOPA) was similar to the best-treated state before surgery (DOPA) for the PD-GPi group and the PD-control group. For the PD-STN group, there were more lateral weight shifts, a delayed foot-off, and a greater number of steps required to recover balance in DBS+DOPA after surgery compared with DOPA before surgery. Within the STN group five subjects who did not fall during the experiment before surgery fell at least once after surgery, whereas the number of falls in the GPi and PD-control groups were unchanged. DBS did not improve the compensatory step response needed to recover from balance perturbations in the GPi group and caused delays in the preparation phase of the step in the STN group.

Item Details

Item Type:Refereed Article
Keywords:Parkinson's disease, balance, compensatory stepping, deep brain stimulation
Research Division:Biomedical and Clinical Sciences
Research Group:Neurosciences
Research Field:Neurosciences not elsewhere classified
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:St George, RJ (Dr Rebecca St George)
ID Code:110079
Year Published:2015
Web of Science® Times Cited:14
Deposited By:Medicine
Deposited On:2016-07-12
Last Modified:2017-11-06

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