RESUMO
Aim of this study was to investigate whether Deep Brain Stimulation (DBS) of the Centre Median Nucleus/Parafascicular (CM/PF) Complex is useful in reducing extrapyramidal symptoms in advanced Parkinson's Disease (PD) patients. In particular, we compared the action of CM/PF and subthalamic nucleus (STN) DBS on resting hand tremor using EMG surface of ulnar and radial right-hand muscles. Our results show that C/M DBS is very effective in reducing tremor, indicating this complex as a new target in advanced PD patients.
Assuntos
Estimulação Encefálica Profunda , Núcleos Intralaminares do Tálamo/fisiologia , Doença de Parkinson/complicações , Tremor/terapia , Adulto , Antiparkinsonianos/uso terapêutico , Doenças dos Gânglios da Base/etiologia , Doenças dos Gânglios da Base/terapia , Eletrodos Implantados , Eletromiografia , Feminino , Humanos , Levodopa/uso terapêutico , Masculino , Pessoa de Meia-Idade , Procedimentos Neurocirúrgicos , Tremor/etiologiaRESUMO
OBJECTIVE: In this study, the validity of a motor task, i.e., the Global Mobility Task (GMT), was assessed in a group of Parkinson's disease (PD) patients. PATIENTS AND METHODS: Fifty-eight PD patients (mean age: 68.7 years) and 18 healthy subjects (mean age: 65.8 years) were enrolled in the study. The GMT measures the ability of an adult to roll over on the floor and stand up in five steps using two parameters: 'Time' and 'Score', i.e., the time needed and the ability to perform each step of the task. As the GMT has never been evaluated before, internal consistency and concurrent and discriminative validity were considered in assessing its characteristics in a group of PD patients at the beginning and at the end of a motor rehabilitation program. To determine whether the GMT could also quantify the extrapyramidal impairment, we compared data collected using this task with data obtained using clinical scales such as the Unified Parkinson's Disease Rating Scale III (UPDRS part III) and Hoehn & Yahr's score. RESULTS: Results showed that the GMT had good consistency and inter-rater reproducibility, was closely related to clinical scales and was able to detect the amelioration of extrapyramidal symptoms at the end of the motor rehabilitation program. CONCLUSION: we propose the GMT as a tool for measuring impaired mobility in PD patients and for evaluating the objective effects of motor rehabilitation programs.
