Reference : Additive Effect of Dopaminergic Medication on Gait Under Single and Dual-Tasking Is G...
Scientific journals : Article
Human health sciences : Neurology
Systems Biomedicine
Additive Effect of Dopaminergic Medication on Gait Under Single and Dual-Tasking Is Greater Than of Deep Brain Stimulation in Advanced Parkinson Disease With Long-duration Deep Brain Stimulation.
Langer, Agnes [> >]
Lucke-Paulig, Lara [> >]
Gassner, Lucia [> >]
Krüger, Rejko mailto [University of Luxembourg > Luxembourg Centre for Systems Biomedicine (LCSB) > Translational Neuroscience]
Weiss, Daniel [> >]
Gharabaghi, Alireza [> >]
Zach, Heidemarie [> >]
Maetzler, Walter [> >]
Hobert, Markus A. [> >]
Neuromodulation : journal of the International Neuromodulation Society
United States
[en] Deep brain stimulation ; Parkinson disease ; dopaminergic medication ; dual task ; dual-task costs
[en] INTRODUCTION: Patients with advanced Parkinson disease (PD) often experience problems with mobility, including walking under single- (ST) and dual-tasking (DT) conditions. The effects of deep brain stimulation in the subthalamic nucleus (DBS) versus dopaminergic medication (Med) on these conditions are not well investigated. MATERIALS AND METHODS: We used two ST and two DT-gait paradigms to evaluate the effect of DBS and dopaminergic medication on gait parameters in 14 PD patients (mean age 66 ± 8 years) under DBS(OFF)/Med(ON), DBS(ON)/Med(OFF), and DBS(ON)/Med(ON) conditions. They performed standardized 20-meter walks with convenient and fast speed. To test DT capabilities, they performed a checking-boxes and a subtraction task during fast-paced walking. Quantitative gait analysis was performed using a tri-axial accelerometer (Dynaport, McRoberts, The Netherlands). Dual-task costs (DTC) of gait parameters and secondary task performance were compared intraindividually between DBS(OFF)/Med(ON) vs DBS(ON)/Med(ON), and DBS(ON)/Med(OFF) vs DBS(ON)/Med(ON) to estimate responsiveness. RESULTS: Dopaminergic medication increased gait speed and cadence at convenient speed. It increased cadence and decreased number of steps at fast speed, and improved DTC of cadence during the checking boxes and DTC of cadence and number of steps during the subtraction tasks. DBS only improved DTC of cadence during the checking boxes and DTC of gait speed during the subtraction task. CONCLUSION: Dopaminergic medication showed larger additional effects on temporal gait parameters under ST and DT conditions in advanced PD than DBS. These results, after confirmation in independent studies, should be considered in the medical management of advanced PD patients with gait and DT deficits.
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Copyright © 2022 International Neuromodulation Society. Published by Elsevier Inc. All rights reserved.

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