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document
The effect of deep brain stimulation randomized by site on balance in Parkinson 's disease . BACKGROUND The effect of the surgical site of DBS on balance and gait in Parkinson 's Disease ( PD ) is uncertain . This is the first double-blind study of subjects randomized to either the STN ( N = 14 ) or GPi ( N = 14 ) who were assessed on a range of clinical balance measures . METHODS Balance testing occurred before and 6 months postsurgery . A control PD group was tested over the same period without surgery ( N = 9 ) . All subjects were tested on and off medication and DBS subjects were also tested on and off DBS . The Postural Instability and Gait Disability items of the UPDRS and additional functional tests , which we call the Balance and Gait scale , were assessed . Activities of Balance Confidence and Activities of Daily Living questionnaires were also recorded . RESULTS Balance was not different between the best-treated states before and after DBS surgery for both sites . Switching DBS on improved balance scores , and scores further improved with medication , compared to the off state . The GPi group showed improved performance in the postsurgery off state and better ratings of balance confidence after surgery , compared to the STN group . CONCLUSIONS Clinical measures of balance function for both the STN and GPi sites showed that balance did not improve beyond the best medically treated state before surgery . Both clinical balance testing in the off/off state and self-reported balance confidence after surgery showed better performance in the GPi than the STN group .
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Intervention_Educational
deep brain stimulation
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Intervention_Educational
STN
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Intervention_Educational
GPi
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Intervention_Control
control
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Intervention_Pharmacological
on and off medication
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Intervention_Physical
on and off DBS
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Outcome_Physical
The Postural Instability and Gait Disability items of the UPDRS and additional functional tests
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Outcome_Mental
Activities of Balance Confidence and Activities of Daily Living questionnaires
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Outcome_Other
balance scores
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Outcome_Mental
balance confidence