Hypokinetic gait changes induced by bilateral pallidal deep brain stimulation for segmental dystonia

• Published in: Gait & posture 2016-09, Vol.49 (NA), p.358-363
• Main Authors: Wolf, Marc E., MD, Capelle, Hans H., MD, Bäzner, Hansjörg, MD, Hennerici, Michael G., MD, Krauss, Joachim K., MD, Blahak, Christian, MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Deep brain stimulation; Deep Brain Stimulation - methods; Dystonia; Dystonia - complications; Dystonia - physiopathology; Dystonia - rehabilitation; Female; Gait; Gait - physiology; Globus Pallidus - physiopathology; Globus pallidus internus; Humans; Hypokinesia; Hypokinesia - etiology; Hypokinesia - physiopathology; Hypokinesia - rehabilitation; Male; Middle Aged; Orthopedics; Treatment Outcome
• ISSN: 0966-6362; 1879-2219
• DOI: 10.1016/j.gaitpost.2016.07.301

•First prospective quantitative evaluation of gait changes after GPi DBS.•Finding and detailed description of hypokinetic gait with GPi DBS.•New aspect of altered gait variability. Deep brain stimulation (DBS) of the globus pallidus internus (GPi) has been established as an effective and safe treatment for dystonia. In general, side effects are rare, but there is increasing evidence that GPi DBS in dystonia can induce hypokinetic symptoms like micrographia or freezing of gait. We aimed to evaluate and quantify possible changes of gait following bilateral chronic GPi DBS for dystonia by computerized gait analyses. We prospectively performed computerized gait analysis in ten consecutive patients (mean age 57.8+/−14.3 years) with segmental dystonia but without involvement of lower trunk or legs who were treated with bilateral GPi DBS. Using pressure sensitive insoles, several parameters were measured preoperatively (pre-OP) and at a median of 7 months postoperatively. The mean step length significantly decreased from 60.0+/−6.9cm pre-OP to 54.3+/−6.4cm with GPi DBS (p