Postural Instability and Risk of Falls in Patients with Parkinson’s Disease Treated with Deep Brain Stimulation: A Stabilometric Platform Study
Postural instability (PI) in Parkinson’s disease (PD) exposes patients to an increased risk of falls (RF). While dopaminergic therapy and deep brain stimulation (DBS) improve motor performance in advanced PD patients, their effects on PI and RF remain elusive. PI and RF were assessed using a stabilo...
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MDPI AG
2023-08-01
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| Series: | Brain Sciences |
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| Online Access: | https://www.mdpi.com/2076-3425/13/9/1243 |
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| author | Giorgio Leodori Marco Santilli Nicola Modugno Michele D’Avino Maria Ilenia De Bartolo Andrea Fabbrini Lorenzo Rocchi Antonella Conte Giovanni Fabbrini Daniele Belvisi |
| author_facet | Giorgio Leodori Marco Santilli Nicola Modugno Michele D’Avino Maria Ilenia De Bartolo Andrea Fabbrini Lorenzo Rocchi Antonella Conte Giovanni Fabbrini Daniele Belvisi |
| author_sort | Giorgio Leodori |
| collection | DOAJ |
| description | Postural instability (PI) in Parkinson’s disease (PD) exposes patients to an increased risk of falls (RF). While dopaminergic therapy and deep brain stimulation (DBS) improve motor performance in advanced PD patients, their effects on PI and RF remain elusive. PI and RF were assessed using a stabilometric platform in six advanced PD patients. Patients were evaluated in OFF and ON dopaminergic medication and under four DBS settings: with DBS off, DBS bilateral, and unilateral DBS of the more- or less-affected side. Our findings indicate that dopaminergic medication by itself exacerbated PI and RF, and DBS alone led to a decline in RF. No combination of medication and DBS yielded a superior improvement in postural control compared to the baseline combination of OFF medication and the DBS-off condition. Yet, for ON medication, DBS significantly improved both PI and RF. Among DBS conditions, DBS bilateral provided the most favorable outcomes, improving PI and RF in the ON medication state and presenting the smallest setbacks in the OFF state. Conversely, the more-affected side DBS was less beneficial. These preliminary results could inform therapeutic strategies for advanced PD patients experiencing postural disorders. |
| first_indexed | 2024-03-10T22:59:51Z |
| format | Article |
| id | doaj.art-eb7f6f8583314487aea2e86d595b99f8 |
| institution | Directory Open Access Journal |
| issn | 2076-3425 |
| language | English |
| last_indexed | 2024-03-10T22:59:51Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Brain Sciences |
| spelling | doaj.art-eb7f6f8583314487aea2e86d595b99f82023-11-19T09:48:15ZengMDPI AGBrain Sciences2076-34252023-08-01139124310.3390/brainsci13091243Postural Instability and Risk of Falls in Patients with Parkinson’s Disease Treated with Deep Brain Stimulation: A Stabilometric Platform StudyGiorgio Leodori0Marco Santilli1Nicola Modugno2Michele D’Avino3Maria Ilenia De Bartolo4Andrea Fabbrini5Lorenzo Rocchi6Antonella Conte7Giovanni Fabbrini8Daniele Belvisi9IRCCS Neuromed, 86077 Pozzilli, ItalyIRCCS Neuromed, 86077 Pozzilli, ItalyIRCCS Neuromed, 86077 Pozzilli, ItalyIRCCS Neuromed, 86077 Pozzilli, ItalyDepartment of Human Neuroscience, University of Rome “Sapienza”, 00185 Rome, ItalyDepartment of Human Neuroscience, University of Rome “Sapienza”, 00185 Rome, ItalyDepartment of Medical Sciences and Public Health, University of Cagliari, 09042 Cagliari, ItalyIRCCS Neuromed, 86077 Pozzilli, ItalyIRCCS Neuromed, 86077 Pozzilli, ItalyIRCCS Neuromed, 86077 Pozzilli, ItalyPostural instability (PI) in Parkinson’s disease (PD) exposes patients to an increased risk of falls (RF). While dopaminergic therapy and deep brain stimulation (DBS) improve motor performance in advanced PD patients, their effects on PI and RF remain elusive. PI and RF were assessed using a stabilometric platform in six advanced PD patients. Patients were evaluated in OFF and ON dopaminergic medication and under four DBS settings: with DBS off, DBS bilateral, and unilateral DBS of the more- or less-affected side. Our findings indicate that dopaminergic medication by itself exacerbated PI and RF, and DBS alone led to a decline in RF. No combination of medication and DBS yielded a superior improvement in postural control compared to the baseline combination of OFF medication and the DBS-off condition. Yet, for ON medication, DBS significantly improved both PI and RF. Among DBS conditions, DBS bilateral provided the most favorable outcomes, improving PI and RF in the ON medication state and presenting the smallest setbacks in the OFF state. Conversely, the more-affected side DBS was less beneficial. These preliminary results could inform therapeutic strategies for advanced PD patients experiencing postural disorders.https://www.mdpi.com/2076-3425/13/9/1243deep brain stimulationfall riskfallsParkinson’s diseasepostural instabilitystabilometric platform |
| spellingShingle | Giorgio Leodori Marco Santilli Nicola Modugno Michele D’Avino Maria Ilenia De Bartolo Andrea Fabbrini Lorenzo Rocchi Antonella Conte Giovanni Fabbrini Daniele Belvisi Postural Instability and Risk of Falls in Patients with Parkinson’s Disease Treated with Deep Brain Stimulation: A Stabilometric Platform Study Brain Sciences deep brain stimulation fall risk falls Parkinson’s disease postural instability stabilometric platform |
| title | Postural Instability and Risk of Falls in Patients with Parkinson’s Disease Treated with Deep Brain Stimulation: A Stabilometric Platform Study |
| title_full | Postural Instability and Risk of Falls in Patients with Parkinson’s Disease Treated with Deep Brain Stimulation: A Stabilometric Platform Study |
| title_fullStr | Postural Instability and Risk of Falls in Patients with Parkinson’s Disease Treated with Deep Brain Stimulation: A Stabilometric Platform Study |
| title_full_unstemmed | Postural Instability and Risk of Falls in Patients with Parkinson’s Disease Treated with Deep Brain Stimulation: A Stabilometric Platform Study |
| title_short | Postural Instability and Risk of Falls in Patients with Parkinson’s Disease Treated with Deep Brain Stimulation: A Stabilometric Platform Study |
| title_sort | postural instability and risk of falls in patients with parkinson s disease treated with deep brain stimulation a stabilometric platform study |
| topic | deep brain stimulation fall risk falls Parkinson’s disease postural instability stabilometric platform |
| url | https://www.mdpi.com/2076-3425/13/9/1243 |
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