Effects of the combined treatment of bilateral subthalamic nucleus stimulation and levodopa on balance and mobility in Parkinson's disease A kombinált kétoldali subthalamicusmag-stimuláció és levodopakezelés hatása az egyensúlyra és a mobilitásra Parkinson-kórban


ŞİMŞEK ERDEM N., GÜNEŞ GENCER G. Y., UÇAR T., Özkaynak S. S.

Ideggyogyaszati Szemle, cilt.76, sa.5-6, ss.173-179, 2023 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 76 Sayı: 5-6
  • Basım Tarihi: 2023
  • Doi Numarası: 10.18071/isz.76.0173
  • Dergi Adı: Ideggyogyaszati Szemle
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE
  • Sayfa Sayıları: ss.173-179
  • Anahtar Kelimeler: balance, bilateral chronic subthalamic nucleus stimulation, levodopa, mobility, Parkinson's disease
  • Akdeniz Üniversitesi Adresli: Evet

Özet

Background and purpose - To evaluate the efficacy of the combined therapy of bilateral subthalamic nucleus deep brain stimulation (STN-DBS) and dopaminergic medication on balance and mobility in patients with Parkinson's disease (PD). Methods - Eighteen PD patients under bilateral STN-DBS stimulation therapy, were enrolled in this study. Unified Parkinson's Disease Rating Scale (UPDRS) was applied to assess the patients' clinical characteristics. UPDRS part III postural instability/ gait disorder (PIGD) scores (sum of items 3.9-3.13) and UPDRS part III postural stability item (item 3.12) were calculated separately. Patients were evaluated with Berg Balance Scale (BBS), Mini-Balance Evaluation Systems Test (Mini-BESTest), Timed Up and Go (TUG) test, dual-task TUG test, and Forward Functional Reach (FFR) Test in two conditions: Stimulation-ON (stim-ON)/Medication-ON (Med-ON) and Stimulation-OFF (Stim-OFF)/ Med-ON Results - The mean age of patients was 59.5±9.1 (R: 41-71) years. The UPDRS part III total score and PIGD subsection score significantly improved after stimulation (p=0.001), but the postural instability item of the UPDRS part III did not change significantly (p=0.1). There were no significant differences between the Stim-ON/Med-ON and Stim-OFF/Med-ON conditions, in terms of total Mini-BESTest total scores, total BBS score, FFR test score (p>0.05 for all of them). TUG test was significantly improved in the Stim-ON/Med-ON condition compared to Stim-OFF/Med-ON condition (p=0.03), but DT-TUG test did not change (p=0.1). Conclusion - Combined bilateral STN-DBS and dopaminergic medication therapy had an additional improvement on motor symptoms and mobility performance, but not on balance and dual-task mobility.