ArticleFrontiers in neurology2017
The Dominant-Subthalamic Nucleus Phenomenon in Bilateral Deep Brain Stimulation for Parkinson's Disease: Evidence from a Gait Analysis Study.
Article in Frontiers in neurology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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14 citing papers in PubMed.
- Lateralized Subthalamic Stimulation for Axial Dysfunction in Parkinson's Disease: Exploratory Outcomes and Open-Label Extension.Movement disorders clinical practice · 2024Trial
- Ventral STN stimulation is associated with improved axial motor outcomes in Parkinson's disease.Journal of neural transmission (Vienna, Austria : 1996) · 2025Article
- Unilateral and Bilateral Subthalamic Deep Brain Stimulation Differently Favour Apathy in Parkinson's Disease.The European journal of neuroscience · 2025Article
- Biomechanics Parameters of Gait Analysis to Characterize Parkinson's Disease: A Scoping Review.Sensors (Basel, Switzerland) · 2025Article
- Impact of deep brain stimulation on gait in Parkinson disease: A kinematic study.Gait & posture · 2024Article
- "Suboptimal" placement of STN DBS electrodes as a novel strategy in Parkinson's disease?Acta neurochirurgica · 2023Article
- Association of 7-Day Profiles of Motor Activity in Marital Dyads with One Component Affected by Parkinson's Disease.Sensors (Basel, Switzerland) · 2023Article
- Troubleshooting Gait Disturbances in Parkinson's Disease With Deep Brain Stimulation.Frontiers in human neuroscience · 2022Review
- Lateralized effects of deep brain stimulation in Parkinson's disease: evidence and controversies.NPJ Parkinson's disease · 2021Review
- Sign-specific stimulation 'hot' and 'cold' spots in Parkinson's disease validated with machine learning.Brain communications · 2021Article
- Surface Electromyography Applied to Gait Analysis: How to Improve Its Impact in Clinics?Frontiers in neurology · 2020Article
- Effect of Parkinson's disease and two therapeutic interventions on muscle activity during walking: a systematic review.NPJ Parkinson's disease · 2020Review
- Neuromodulation targets pathological not physiological beta bursts during gait in Parkinson's disease.Neurobiology of disease · 2018Article
- Motor outcome and electrode location in deep brain stimulation in Parkinson's disease.Brain and behavior · 2018Article
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5 authors.
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Abstract
backgroundIt has been suggested that parkinsonian [Parkinson's disease (PD)] patients might have a "dominant" (DOM) subthalamic nucleus (STN), whose unilateral electrical stimulation [deep brain stimulation (DBS)] could lead to an improvement in PD symptoms similar to bilateral STN-DBS.
objectivesSince disability in PD patients is often related to gait problems, in this study, we wanted to investigate in a group of patients bilaterally implanted for STN-DBS: (1) if it was possible to identify a subgroup of subjects with a dominant STN; (2) in the case, if the unilateral stimulation of the dominant STN was capable to improve gait abnormalities, as assessed by instrumented multifactorial gait analysis, similarly to what observed with bilateral stimulation.
methodsWe studied 10 PD patients with bilateral STN-DBS. A clinical evaluation and a kinematic, kinetic, and electromyographic (EMG) analysis of overground walking were performed-off medication-in four conditions: without stimulation, with bilateral stimulation, with unilateral right or left STN-DBS. Through a hierarchical agglomerative cluster analysis based on motor Unified Parkinson's Disease Rating Scale scores, it was possible to separate patients into two groups, based on the presence (six patients, DOM group) or absence (four patients, NDOM group) of a dominant STN.
resultsIn the DOM group, both bilateral and unilateral stimulation of the dominant STN significantly increased gait speed, stride length, range of motion of lower limb joints, and peaks of moment and power at the ankle joint; moreover, the EMG activation pattern of distal leg muscles was improved. The unilateral stimulation of the non-dominant STN did not produce any significant effect. In the NDOM group, only bilateral stimulation determined a significant improvement of gait parameters.
conclusionIn the DOM group, the effect of unilateral stimulation of the dominant STN determined an improvement of gait parameters similar to bilateral stimulation. The pre-surgical identification of these patients, if possible, could allow to reduce the surgical risks and side effects of DBS adopting a unilateral approach.
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