Effects of the combined treatment of bilateral subthalamic nucleus stimulation and levodopa on balance and mobility in Parkinson's disease A kombinált kétoldali subthalamicusmag-stimuláció és levodopakezelés hatása az egyensúlyra és a mobilitásra Parkinson-kórban


Ideggyogyaszati Szemle, vol.76, no.5-6, pp.173-179, 2023 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 76 Issue: 5-6
  • Publication Date: 2023
  • Doi Number: 10.18071/isz.76.0173
  • Journal Name: Ideggyogyaszati Szemle
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE
  • Page Numbers: pp.173-179
  • Keywords: balance, bilateral chronic subthalamic nucleus stimulation, levodopa, mobility, Parkinson's disease
  • Akdeniz University Affiliated: Yes


Background and purpose - To evaluate the efficacy of the combined therapy of bilateral subthalamic nucleus deep brain stimulation (STN-DBS) and dopaminergic medication on balance and mobility in patients with Parkinson's disease (PD). Methods - Eighteen PD patients under bilateral STN-DBS stimulation therapy, were enrolled in this study. Unified Parkinson's Disease Rating Scale (UPDRS) was applied to assess the patients' clinical characteristics. UPDRS part III postural instability/ gait disorder (PIGD) scores (sum of items 3.9-3.13) and UPDRS part III postural stability item (item 3.12) were calculated separately. Patients were evaluated with Berg Balance Scale (BBS), Mini-Balance Evaluation Systems Test (Mini-BESTest), Timed Up and Go (TUG) test, dual-task TUG test, and Forward Functional Reach (FFR) Test in two conditions: Stimulation-ON (stim-ON)/Medication-ON (Med-ON) and Stimulation-OFF (Stim-OFF)/ Med-ON Results - The mean age of patients was 59.5±9.1 (R: 41-71) years. The UPDRS part III total score and PIGD subsection score significantly improved after stimulation (p=0.001), but the postural instability item of the UPDRS part III did not change significantly (p=0.1). There were no significant differences between the Stim-ON/Med-ON and Stim-OFF/Med-ON conditions, in terms of total Mini-BESTest total scores, total BBS score, FFR test score (p>0.05 for all of them). TUG test was significantly improved in the Stim-ON/Med-ON condition compared to Stim-OFF/Med-ON condition (p=0.03), but DT-TUG test did not change (p=0.1). Conclusion - Combined bilateral STN-DBS and dopaminergic medication therapy had an additional improvement on motor symptoms and mobility performance, but not on balance and dual-task mobility.