Article

The pedunculopontine tegmental nucleus (PPTg) is a component of the locomotor
mesencephalic area. In recent years it has been considered a new surgical site
for deep brain stimulation (DBS) in movement disorders. Here, using objective
kinematic and spatio-temporal gait analysis, we report the impact of low
frequency (40 Hz) unilateral PPTg DBS in ten patients suffering from idiopathic
Parkinson's disease with drug-resistant gait and axial disabilities. Patients
were studied for gait initiation (GI) and steady-state level walking (LW) under
residual drug therapy. In the LW study, a straight walking task was employed.
Patients were compared with healthy age-matched controls. The analysis revealed
that GI, cadence, stride length and left pelvic tilt range of motion (ROM)
improved under stimulation. The duration of the S1 and S2 sub-phases of the
anticipatory postural adjustment phase of GI was not affected by stimulation,
however a significant improvement was observed in the S1 sub-phase in both the
backward shift of centre of pressure and peak velocity. Speed during the swing
phase, step width, stance duration, right pelvic tilt ROM phase, right and left
hip flexion-extension ROM, and right and left knee ROM were not modified.
Overall, the results show that unilateral PPTg DBS may affect GI and specific
spatio-temporal and kinematic parameters during unconstrained walking on a
straight trajectory, thus providing further support to the importance of the PPTg
in the modulation of gait in neurodegenerative disorders.
CI - Copyright (c) 2014 Elsevier B.V. All rights reserved.

Langue : ANGLAIS