Abstract Details

Title Effect of Subthalamic Nucleus Deep Brain Stimulation on Gait Stability during Dual Tasking Conditions in Patients with Parkinson's Disease

Topic Movement Disorders

Presentation(s) P04 - (-)

Poster/Presentation
Number 179

Objective

Background BACKGROUND: Balance and gait impairments, such as freezing of gait (FoG), are major sources of disability and have devastating effects on Parkinson's disease (PD) patients. There is increasing evidence that suggests that maintaining gait stability requires both cognitive and sensorimotor processes. Dual tasking (DT) is used to examine the effects of cognitively challenging tasks on primary activities such as walking. The effect of subthalamic nucleus deep brain stimulation (STN DBS) on gait stability is not well understood.

Design/Methods DESIGN/METHODS: Ten patients (age: 60.5 ± 2.3)with idiopathic PD and bilateral STN DBS were tested at least six months after surgery. For each patient we collected the following data in two stimulator conditions (with and without bilateral DBS): clinical evaluation (UPDRS subscale III) and gait (using GAITRite mat). Data from the Gait and Falls questionnaire and the new FoG questionnaire was also collected. Gait data was collected for two conditions: normal and dual tasking (walked at their normal pace while performing serial three subtractions). Each walk was 2 minutes long.

Results RESULTS: DBS significantly improved UPDRS score and several gait parameters. DT had significant detrimental effects on gait in (-)Falls, (+)Falls, (-)FoG and (+)FoG groups. However, DBS minimized the detrimental effect of DT on bilateral gait coordination, especially in patients without a history of falls. On the other hand, DBS increased gait asymmetry.

Conclusions CONCLUSIONS: STN DBS improves several gait parameters, but may worsen gait asymmetry. STN DBS may decrease the effects of dual tasking on bilateral gait coordination. Additionally, the response of gait to STN DBS varies based on history of falls and FoG.

Authors/Disclosures
Travis Larsh PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
Andrew P. Duker, MD (University of Cincinnati)	No disclosure on file
Ramya Raghavan	No disclosure on file
	No disclosure on file
Fredy J. Revilla, MD, FAAN (Neuroscience Associates)	Dr. Revilla has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TEVA . Dr. Revilla has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for TEVA .
Steven P. Sparagana, MD, FAAN	Dr. Sparagana has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Greenwich Biosciences. Dr. Sparagana has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Nobelpharma. The institution of Dr. Sparagana has received research support from Greenwich Biosciences. The institution of Dr. Sparagana has received research support from Tuberous Sclerosis Alliance. The institution of Dr. Sparagana has received research support from Novartis. Dr. Sparagana has a non-compensated relationship as a Professional Advisory Board Member, committee member with Tuberous Sclerosis Alliance that is relevant to AAN interests or activities.
Zbigniew K. Wszolek, MD, FAAN (Mayo Clinic- Jacksonville)	Dr. Wszolek has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Polish Neurological Society/Via Medica. Dr. Wszolek has received intellectual property interests from a discovery or technology relating to health care.

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