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Influence de la stimulation chronique bilatérale des noyaux sous-thalamiques sur le contrôle postural des patients atteints de maladie de Parkinson évoluée

Abstract : Objectives : Parkinson's disease (PD), the most common degenerative disease of the basal ganglia, is known to affect balance control. Bilateral chronic stimulation of the subthalamic nucleus (STN) is now recognised to be a good therapeutic choice for advanced PD. Nevertheless, the effects of STN stimulation on postural control are still the subject of much debate. The aim of this study was to assess the impact of bilateral STN stimulation on balance control in PD and to determine how basal ganglia-related sensorimotor modifications act on neurosensorial organisation of balance and motor postural programming. Methods : Twelve subjects aged from 45 to 70 years underwent Unified Parkinson's Disease Rating Scale (UPDRS) motor (part III) clinical tests, static and dynamic posturography, including sensory organisation and adaptation tests shortly before and six months after bilateral implantation of electrodes into the STN. Results : Post-operative static test showed an improvement in postural control precision. Dynamic test highlighted the decrease in the number of falls and the ability of the patients to develop more appropriate sensorimotor strategies when stimulated. Sensory organization test showed an improvement of equilibrium score and thus, a better resolution of sensorial conflicts. Conclusions : STN stimulation has a synergistic effect with levodopa (L-DOPA) for postural control. Accordingly, non-dopaminergic pathways could be involved in postural regulation and STN stimulation may influence the functioning of these pathways.
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Theses
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http://docnum.univ-lorraine.fr/prive/SCD_T_2005_0144_COLNAT.pdf
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https://hal.univ-lorraine.fr/tel-01746657
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Submitted on : Thursday, March 29, 2018 - 10:42:04 AM
Last modification on : Tuesday, May 26, 2020 - 3:27:22 PM

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  • HAL Id : tel-01746657, version 1

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Sophie Colnat. Influence de la stimulation chronique bilatérale des noyaux sous-thalamiques sur le contrôle postural des patients atteints de maladie de Parkinson évoluée. Neurosciences [q-bio.NC]. Université Henri Poincaré - Nancy 1, 2005. Français. ⟨NNT : 2005NAN10144⟩. ⟨tel-01746657⟩

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