Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Postural instability and risk of falls in patients with Parkinson’s disease treated with deep brain stimulation: a stabilometric platform study

Giorgio Leodori
ORCID logo ,
Marco Santilli
,
Nicola Modugno
,
Michele D’Avino
,
Maria Ilenia De Bartolo
ORCID logo ,
Andre Fabbrini
,
Lorenzo Rocchi
,
Antonella Conte
ORCID logo ,
Giovanni Fabbrini
* ,
Daniele Belvisi
Version 1 : Received: 4 August 2023 / Approved: 7 August 2023 / Online: 7 August 2023 (12:03:46 CEST)

A peer-reviewed article of this Preprint also exists.

Leodori, G.; Santilli, M.; Modugno, N.; D’Avino, M.; De Bartolo, M.I.; Fabbrini, A.; Rocchi, L.; Conte, A.; Fabbrini, G.; Belvisi, D. Postural Instability and Risk of Falls in Patients with Parkinson’s Disease Treated with Deep Brain Stimulation: A Stabilometric Platform Study. Brain Sci. 2023, 13, 1243. Leodori, G.; Santilli, M.; Modugno, N.; D’Avino, M.; De Bartolo, M.I.; Fabbrini, A.; Rocchi, L.; Conte, A.; Fabbrini, G.; Belvisi, D. Postural Instability and Risk of Falls in Patients with Parkinson’s Disease Treated with Deep Brain Stimulation: A Stabilometric Platform Study. Brain Sci. 2023, 13, 1243.

Abstract

Postural instability (PI) in Parkinson’s disease (PD) exposes patients to increased risk of falls (RF). Although dopaminergic therapy and deep brain stimulation (DBS) improve motor performance in advanced PD patients, their effects on PI and RF are not clear. PI and RF were assessed by a stabilometric platform in 6 advanced PD patients. Patients were evaluated on and off dopaminergic medication and four DBS conditions: bilateral-DBS, DBS of the more- or less-affected side and DBS-off. Dopaminergic medication alone worsened PI and RF, DBS alone worsened RF, and no medication/DBS combination produced an improvement in postural control with respect to the OFF-medication/DBS-off condition. When ON-medication, PI and RF significantly improved after turning the DBS on, regardless of medication condition. Among DBS conditions, bilateral-DBS provided the maximal improvement of PI and RF when ON medication, and minimal worsening of PI and RF when OFF medication, whereas patients performed worse when in most-affected side DBS condition. These results can help in developing the best therapeutic strategy for postural disorders in patients with advanced PD.

Keywords

deep brain stimulation; fall risk; falls; parkinson’s disease; postural instability; stabilometric platform; movement disorders; postural control.

Subject

Medicine and Pharmacology, Neuroscience and Neurology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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