Objective: Gait and freezing of gait (FoG) are highly relevant to the outcomes of subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson's disease (PD). Previous studies pointed to variable response to combined dopaminergic and STN-DBS treatment. Here, we performed a prospective exploratory study on associations of preoperative clinical and kinematic gait measures with quantitative gait and FoG outcomes after STN-DBS implantation.Methods: We characterized 18 consecutive PD patients (13 freezers) before and after STN-DBS implantation. The patients received preoperative levodopa challenges (MedOff vs. MedOn) and a postoperative reassessment at 6 months from surgery in MedOn/StimOn condition. We correlated the FoG outcome, calculated as improvement of Freezing of Gait Assessment Course (FoG-AC) from baseline MedOff to 6-month follow-up MedOn/StimOn, with the levodopa response of preoperative clinical and kinematic gait measures. We considered measures with significant correlations for a multiple regression model.Results: We found that the postoperative gait and FoG outcomes were associated with the preoperative levodopa response of clinical and kinematic gait measures. In particular, preoperative levodopa sensitivity of FoG showed high correlation with a favorable quantitative FoG outcome. Among kinematic measures, preoperative levodopa response of stride length and range of motion showed high correlation with favorable FoG outcome. In addition, the preoperative levodopa sensitivity of FoG predicted postoperative FoG outcome with high accuracy (R2 = 0.952; 95% CI: 0.95–1.29; P < 0.001).Conclusions: Preoperative clinical and kinematic measures correlated with favorable postoperative gait and FoG outcomes. The findings should be reproduced in larger and independent cohorts to verify their predictive value.


    Access

    Download


    Export, share and cite



    Title :

    Clinical and Kinematic Correlates of Favorable Gait Outcomes From Subthalamic Stimulation


    Contributors:

    Publication date :

    2020-01-01


    Remarks:

    Frontiers in neurology 11, 212 (2020). doi:10.3389/fneur.2020.00212


    Type of media :

    Article (Journal)


    Type of material :

    Electronic Resource


    Language :

    English



    Classification :

    DDC:    629 / 610



    Effects of Subthalamic and Nigral Stimulation on Gait Kinematics in Parkinson's Disease.

    Scholten, Marlieke / Klemt, Johannes / Heilbronn, Melanie et al. | BASE | 2017

    Free access



    Simultaneous Kinetic and Kinematic Gait Analysis

    Griffon, D.J. / American College of Veterinary Surgeons | British Library Conference Proceedings | 2007


    Are Clinical Impairments Related to Kinematic Gait Variability in Children and Young Adults With Cerebral Palsy?

    Tabard-Fougère, A. / Rutz, D. / Pouliot-Laforte, A. et al. | BASE | 2022

    Free access