Characteristics and prognostic factors of Parkinson's disease patients with abnormal postures subjected to subthalamic nucleus deep brain stimulation

Mihoko Okazaki, Tatsuya Sasaki, Takao Yasuhara, Masahiro Kameda, Takashi Agari, Ittetsu Kin, Ken Kuwahara, Jun Morimoto, Kyohei Kin, Michiari Umakoshi, Yousuke Tomita, Cesario V. Borlongan, Isao Date

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: In Parkinson's disease (PD), abnormal postures are often accompanied, which interfere with rehabilitation and subsequent functional recovery. This study investigated the relationship between clinical characteristics and improvement in abnormal postures of PD patients who received subthalamic nucleus deep brain stimulation (STN-DBS). Methods: Seventy-four PD patients were included in this study. Clinical data were analyzed using the patients’ functional status at pre- and post-STN-DBS, including anteflexion vs. non-anteflexion, scoliosis vs. non-scoliosis, improved anteflexion vs. non-improved anteflexion, and improved scoliosis vs. non-improved scoliosis. Results: In patients with anteflexion, UPDRS III motor score at off medication was worse than that of patients with non-anteflexion. Patients with scoliosis presented with more comorbid spinal deformity and longer disease duration than those without scoliosis. Cobb angle of patients with asymmetrical psoas major and erector spinal muscles was more than that of patients without the asymmetry. Patients with improved anteflexion after STN-DBS had thicker abdominal oblique muscle and transverse abdominal muscle than those of patients without improved anteflexion. Patients with improved scoliosis were significantly younger at PD onset than those without improvement. Conclusions: There were only a few prognostic factors recognized in patients with improved postures. The thick abdominal muscle for anteflexion and younger PD onset for scoliosis were significant factors for improvement by STN-DBS. Rehabilitation designed to maintain muscle for correct postures may contribute to the amelioration of abnormal postures by STN-DBS, although multicenter trials are needed.

Original languageEnglish
JournalParkinsonism and Related Disorders
DOIs
Publication statusAccepted/In press - Jan 1 2018

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Subthalamic Nucleus
Deep Brain Stimulation
Posture
Parkinson Disease
Scoliosis
Abdominal Muscles
Rehabilitation
Muscles
Multicenter Studies

Keywords

  • Abdominal muscle
  • Anteflexion
  • Lumbar muscle
  • Parkinson's disease
  • Scoliosis

ASJC Scopus subject areas

  • Neurology
  • Geriatrics and Gerontology
  • Clinical Neurology

Cite this

Characteristics and prognostic factors of Parkinson's disease patients with abnormal postures subjected to subthalamic nucleus deep brain stimulation. / Okazaki, Mihoko; Sasaki, Tatsuya; Yasuhara, Takao; Kameda, Masahiro; Agari, Takashi; Kin, Ittetsu; Kuwahara, Ken; Morimoto, Jun; Kin, Kyohei; Umakoshi, Michiari; Tomita, Yousuke; Borlongan, Cesario V.; Date, Isao.

In: Parkinsonism and Related Disorders, 01.01.2018.

Research output: Contribution to journalArticle

Okazaki, Mihoko ; Sasaki, Tatsuya ; Yasuhara, Takao ; Kameda, Masahiro ; Agari, Takashi ; Kin, Ittetsu ; Kuwahara, Ken ; Morimoto, Jun ; Kin, Kyohei ; Umakoshi, Michiari ; Tomita, Yousuke ; Borlongan, Cesario V. ; Date, Isao. / Characteristics and prognostic factors of Parkinson's disease patients with abnormal postures subjected to subthalamic nucleus deep brain stimulation. In: Parkinsonism and Related Disorders. 2018.
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abstract = "Objective: In Parkinson's disease (PD), abnormal postures are often accompanied, which interfere with rehabilitation and subsequent functional recovery. This study investigated the relationship between clinical characteristics and improvement in abnormal postures of PD patients who received subthalamic nucleus deep brain stimulation (STN-DBS). Methods: Seventy-four PD patients were included in this study. Clinical data were analyzed using the patients’ functional status at pre- and post-STN-DBS, including anteflexion vs. non-anteflexion, scoliosis vs. non-scoliosis, improved anteflexion vs. non-improved anteflexion, and improved scoliosis vs. non-improved scoliosis. Results: In patients with anteflexion, UPDRS III motor score at off medication was worse than that of patients with non-anteflexion. Patients with scoliosis presented with more comorbid spinal deformity and longer disease duration than those without scoliosis. Cobb angle of patients with asymmetrical psoas major and erector spinal muscles was more than that of patients without the asymmetry. Patients with improved anteflexion after STN-DBS had thicker abdominal oblique muscle and transverse abdominal muscle than those of patients without improved anteflexion. Patients with improved scoliosis were significantly younger at PD onset than those without improvement. Conclusions: There were only a few prognostic factors recognized in patients with improved postures. The thick abdominal muscle for anteflexion and younger PD onset for scoliosis were significant factors for improvement by STN-DBS. Rehabilitation designed to maintain muscle for correct postures may contribute to the amelioration of abnormal postures by STN-DBS, although multicenter trials are needed.",
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T1 - Characteristics and prognostic factors of Parkinson's disease patients with abnormal postures subjected to subthalamic nucleus deep brain stimulation

AU - Okazaki, Mihoko

AU - Sasaki, Tatsuya

AU - Yasuhara, Takao

AU - Kameda, Masahiro

AU - Agari, Takashi

AU - Kin, Ittetsu

AU - Kuwahara, Ken

AU - Morimoto, Jun

AU - Kin, Kyohei

AU - Umakoshi, Michiari

AU - Tomita, Yousuke

AU - Borlongan, Cesario V.

AU - Date, Isao

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objective: In Parkinson's disease (PD), abnormal postures are often accompanied, which interfere with rehabilitation and subsequent functional recovery. This study investigated the relationship between clinical characteristics and improvement in abnormal postures of PD patients who received subthalamic nucleus deep brain stimulation (STN-DBS). Methods: Seventy-four PD patients were included in this study. Clinical data were analyzed using the patients’ functional status at pre- and post-STN-DBS, including anteflexion vs. non-anteflexion, scoliosis vs. non-scoliosis, improved anteflexion vs. non-improved anteflexion, and improved scoliosis vs. non-improved scoliosis. Results: In patients with anteflexion, UPDRS III motor score at off medication was worse than that of patients with non-anteflexion. Patients with scoliosis presented with more comorbid spinal deformity and longer disease duration than those without scoliosis. Cobb angle of patients with asymmetrical psoas major and erector spinal muscles was more than that of patients without the asymmetry. Patients with improved anteflexion after STN-DBS had thicker abdominal oblique muscle and transverse abdominal muscle than those of patients without improved anteflexion. Patients with improved scoliosis were significantly younger at PD onset than those without improvement. Conclusions: There were only a few prognostic factors recognized in patients with improved postures. The thick abdominal muscle for anteflexion and younger PD onset for scoliosis were significant factors for improvement by STN-DBS. Rehabilitation designed to maintain muscle for correct postures may contribute to the amelioration of abnormal postures by STN-DBS, although multicenter trials are needed.

AB - Objective: In Parkinson's disease (PD), abnormal postures are often accompanied, which interfere with rehabilitation and subsequent functional recovery. This study investigated the relationship between clinical characteristics and improvement in abnormal postures of PD patients who received subthalamic nucleus deep brain stimulation (STN-DBS). Methods: Seventy-four PD patients were included in this study. Clinical data were analyzed using the patients’ functional status at pre- and post-STN-DBS, including anteflexion vs. non-anteflexion, scoliosis vs. non-scoliosis, improved anteflexion vs. non-improved anteflexion, and improved scoliosis vs. non-improved scoliosis. Results: In patients with anteflexion, UPDRS III motor score at off medication was worse than that of patients with non-anteflexion. Patients with scoliosis presented with more comorbid spinal deformity and longer disease duration than those without scoliosis. Cobb angle of patients with asymmetrical psoas major and erector spinal muscles was more than that of patients without the asymmetry. Patients with improved anteflexion after STN-DBS had thicker abdominal oblique muscle and transverse abdominal muscle than those of patients without improved anteflexion. Patients with improved scoliosis were significantly younger at PD onset than those without improvement. Conclusions: There were only a few prognostic factors recognized in patients with improved postures. The thick abdominal muscle for anteflexion and younger PD onset for scoliosis were significant factors for improvement by STN-DBS. Rehabilitation designed to maintain muscle for correct postures may contribute to the amelioration of abnormal postures by STN-DBS, although multicenter trials are needed.

KW - Abdominal muscle

KW - Anteflexion

KW - Lumbar muscle

KW - Parkinson's disease

KW - Scoliosis

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