Effect of Dopaminergic Medication on Postural Sway in Advanced Parkinson’s Disease

Frontiers in Neurology

Paul eSuccop¹  Fredy J. Revilla¹  Cyndy eCox²  Andrew P. Duker³  Claudia eJarrin Tejada³  Maureen eGartner³  Ashutosh eMani³  Amit eBhattacharya³  Travis R Larsh⁴ 

[1] Movement Disorders, University of Cincinnati Neuroscience Institute;;Gardner Center for Parkinson’s &University of Cincinnati College of Medicine;Veteran Affairs Medical Center;

关键词: Levodopa;    balance;    Parkinson’s disease;    instability;    Dyskinesia;    fall;   

DOI  :  10.3389/fneur.2013.00202

来源: DOAJ

【 摘 要 】

Background: The effect of dopaminergic therapy on balance in Parkinson’s disease (PD) remains unclear, including previous studies that excluded the effect of dyskinesias or other involuntary movements on postural sway. Additionally, medication’s effects may differ between fallers and non-fallers. In this study, the authors quantify the effect of dopaminergic medication on postural balance (sway) in advanced PD, with and without dyskinesias, and consider the patient’s history of falls. Methods: In 24 patients with advanced idiopathic PD, postural balance was measured using a strain-gauge force platform. Before and after taking dopaminergic medication, the patient’s postural sway was measured at 30-second intervals to determine sway length (SL) and sway area (SA). Data analysis included the presence of dyskinesias during "ON" medication condition and history of previous falls.Results: No significant changes occurred in SL or SA with dopaminergic treatment for fallers without dyskinesias or non-fallers with dyskinesias. However, after dopaminergic treatment, SL and SA were 37.8% and 45% lower, respectively, in non-fallers without dyskinesias (indicating better balance) and were 87.4% and 162.8% higher, respectively, in fallers with dyskinesias (indicating poorer balance). In the ON medication condition, SL and SA were larger in patients with dyskinesias when compared with patients without dyskinesias; SL was larger in fallers than non-fallers in both groups with or without dyskinesias. Conclusions: Dopaminergic medication effects on postural sway could be a predictive factor for fall risk in PD patients with and without dyskinesias: specifically, decreased sway could indicate minimal fall risk whereas no change or increased postural sway could indicate a high risk.

【 授权许可】

Unknown