O040 Ambulatory monitoring of motor fluctuations in Parkinson's disease

Abstract

s of the 17th Annual Meeting of ESMAC, Oral Presentations / Gait & Posture 28S (2008) S1–S48 S29 Conclusions: Our results suggest that LID may compromise balance and independently contribute to postural instability in advanced PD. In those instances, reducing LD or using other antidyskinetic strategies may be beneficial to patients. Introduction: In the presence of LID, PD patients may complain of unsteadiness and impaired balance, yet the influence of LID upon postural stability has not been specifically examined. In this study, we addressed this issue using static and dynamic posturography in patients with advanced PD and typical LID. Patients/Materials and Methods: Eleven patients were OFF and ON, and 12 age-matched healthy controls were included in this study. Relevant postural stability parameters were measured on two force platforms (Kistler, CH), either in quiet standing or when performing leaning tasks designed to stress postural stability. Simultaneously, LID was assessed clinically using a dyskinesia rating scale of severity. Displacement of the center of pressure (COP), range of COP in the medio-lateral (ML) and antero-posterior (AP) directions, and 95% confidence ellipse area were measured as indicators of postural stability and used for comparison analyses (Wilcoxon signed-rank test). Results: There was a good correlation between the clinical scores of dyskinesia severity and the COP displacement (R = 0.74). We found a significant increase of COP displacement in all tasks up to 556% (mean: 125±165%) when patients were ON with LID (888.4±704.2mm, p = 0.004), compared to the OFF state (371.4±106.7mm). In about half of the patients, this increase was marked (>100%). In the presence of LID, the range of COP displacement was significantly higher both in the ML direction (20.5±9.4 vs 56.6±50.6mm, p = 0.003) and in the AP direction (25.1±6.5 vs 40.6±25.3mm, p = 0.041), but with more marked difference in the ML direction. As shown in Figure 1, the 95% confidence ellipse area was also considerably increased in the presence of LID (385±239 vs 2035±2742mm2, p = 0.004).