Gait and Balance Changes with Investigational Peripheral Nerve Cell Therapy during Deep Brain Stimulation in People with Parkinson’s Disease

Authors

Geetanjali Gera, University of KentuckyFollow
Zain Guduru, University of KentuckyFollow
Tritia R. Yamasaki, University of KentuckyFollow
Julie A. Gurwell, University of KentuckyFollow
Monica Chau, University of KentuckyFollow
Anna Krotinger, University of Kentucky
Frederick A. Schmitt, University of KentuckyFollow
John T. Slevin, University of KentuckyFollow
Greg A. Gerhardt, University of KentuckyFollow
Craig G. van Horne, University of KentuckyFollow
Jorge E. Quintero, University of KentuckyFollow

Abstract

Background: The efficacy of deep brain stimulation (DBS) and dopaminergic therapy is known to decrease over time. Hence, a new investigational approach combines implanting autologous injury-activated peripheral nerve grafts (APNG) at the time of bilateral DBS surgery to the globus pallidus interna. Objectives: In a study where APNG was unilaterally implanted into the substantia nigra, we explored the effects on clinical gait and balance assessments over two years in 14 individuals with Parkinson’s disease. Methods: Computerized gait and balance evaluations were performed without medication, and stimulation was in the off state for at least 12 h to best assess the role of APNG implantation alone. We hypothesized that APNG might improve gait and balance deficits associated with PD. Results: While people with a degenerative movement disorder typically worsen with time, none of the gait parameters significantly changed across visits in this 24 month study. The postural stability item in the UPDRS did not worsen from baseline to the 24-month follow-up. However, we measured gait and balance improvements in the two most affected individuals, who had moderate PD. In these two individuals, we observed an increase in gait velocity and step length that persisted over 6 and 24 months. Conclusions: Participants did not show worsening of gait and balance performance in the off therapy state two years after surgery, while the two most severely affected participants showed improved performance. Further studies may better address the long-term maintanenace of these results.

Document Type

Article

Publication Date

4-15-2021

Notes/Citation Information

Published in Brain Sciences, v. 11, issue 4, 500.

© 2021 by the authors. Licensee MDPI, Basel, Switzerland.

This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

Digital Object Identifier (DOI)

https://doi.org/10.3390/brainsci11040500

Funding Information

Funding provided by gifts to the Brain Restoration Center, Ann Hanley Parkinson’s Research Fund, the UK College of Medicine BRAIN Alliance, Tom Dupree for Parkinson’s Disease Research, Pro’s Players For Parkinson’s, the Werner Schmitt endowment for Neurobehavior and Aging, startup funds to CvH, and the National Center for Advancing Translational Sciences, through grant UL1TR001998.

Repository Citation

Gera, Geetanjali; Guduru, Zain; Yamasaki, Tritia R.; Gurwell, Julie A.; Chau, Monica; Krotinger, Anna; Schmitt, Frederick A.; Slevin, John T.; Gerhardt, Greg A.; van Horne, Craig G.; and Quintero, Jorge E., "Gait and Balance Changes with Investigational Peripheral Nerve Cell Therapy during Deep Brain Stimulation in People with Parkinson’s Disease" (2021). Physical Therapy Faculty Publications. 122.
https://uknowledge.uky.edu/rehabsci_facpub/122