Does Subthalamic Deep Brain Stimulation Impact Asymmetry and Dyscoordination of Gait in Parkinson's Disease?

The study was non-randomized, and gait evaluators were not blinded to whether participants had Parkinson's disease or were controls. The sample was small and included few women, so gender-related effects could not be checked. Five people with Parkinson's disease dropped out, one before surgery and four after surgery. The Parkinson group and controls differed in age, sex, height, and weight, and the analysis did not adjust for these differences. Fall history was not collected, so the study could not link increased asymmetry or dyscoordination to falls. Gait was a secondary outcome, and the study did not test unilateral stimulation protocols aimed at gait asymmetry. Most post-surgery assessments were still done with medication, except 3 participants who were completely OFF medication, so medication state varied. The findings are exploratory and need validation in randomized controlled trials before use in clinical rehabilitation settings.

The authors declared no potential conflicts of interest. The study received financial support as a PhD scholarship from the State Secretariat for Education, Research, and Innovation Switzerland.

Do not conclude that DBS improves gait symmetry and coordination. The main motor score improved, but step time asymmetry and left-right stepping dyscoordination increased after surgery, especially in the postural instability and gait disorder group. The study was non-randomized and unblinded.