Interactive effects of GPI stimulation and levodopa on postural control in Parkinson's disease.

Johnson,L, Rodrigues,J, Teo,WP, Walters,S, Stell,R, Thickbroom,G and Mastaglia,F 2015, Interactive effects of GPI stimulation and levodopa on postural control in Parkinson's disease., Gait Posture, vol. 41, no. 4, pp. 929-934, doi: 10.1016/j.gaitpost.2015.03.346.

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Title Interactive effects of GPI stimulation and levodopa on postural control in Parkinson's disease.
Author(s) Johnson,L
Teo,WPORCID iD for Teo,WP
Journal name Gait Posture
Volume number 41
Issue number 4
Start page 929
End page 934
Publisher Elsevier
Place of publication England
Publication date 2015-05
ISSN 1879-2219
Keyword(s) Deep brain stimulation
Parkinson's disease
Postural instability
Static and dynamic posturography
Summary INTRODUCTION: Postural instability is a major source of disability in idiopathic Parkinson's disease (IPD). Deep brain stimulation of the globus pallidus internus (GPI-DBS) improves clinician-rated balance control but there have been few quantitative studies of its interactive effects with levodopa (L-DOPA). The purpose of this study was to compare the short-term and interactive effects of GPI-DBS and L-DOPA on objective measures of postural stability in patients with longstanding IPD. METHODS: Static and dynamic posturography during a whole-body leaning task were performed in 10 IPD patients with bilateral GPI stimulators under the following conditions: untreated (OFF); L-DOPA alone; DBS alone; DBS+L-DOPA, and in 9 healthy Control subjects. Clinical status was assessed using the UPDRS and AIMS Dyskinesia Scale. RESULTS: Static sway was greater in IPD patients in the OFF state compared to the Control subjects and was further increased by L-DOPA and reduced by GPI-DBS. In the dynamic task, L-DOPA had a greater effect than GPI-DBS on improving Start Time, but reduced the spatial accuracy and directional control of the task. When the two therapies were combined, GPI-DBS prevented the L-DOPA induced increase in static sway and improved the accuracy of the dynamic task. CONCLUSION: The findings demonstrate GPI-DBS and L-DOPA have differential effects on temporal and spatial aspects of postural control in IPD and that GPI-DBS counteracts some of the adverse effects of L-DOPA. Further studies on larger numbers of patients with GPI stimulators are required to confirm these findings and to clarify the contribution of dyskinesias to impaired dynamic postural control.
Language eng
DOI 10.1016/j.gaitpost.2015.03.346
Field of Research 110699 Human Movement and Sports Science not elsewhere classified
119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 929999 Health not elsewhere classified
HERDC Research category C1 Refereed article in a scholarly journal
HERDC collection year 2015
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Document type: Journal Article
Collections: Faculty of Health
School of Exercise and Nutrition Sciences
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