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Keywords:

  • Deep brain stimulation;
  • falls;
  • fear of falling;
  • Parkinson’s disease;
  • subthalamic nuclei

Nilsson MH, Rehncrona S, Jarnlo G-B. Fear of falling and falls in people with Parkinson’s disease treated with deep brain stimulation in the subthalamic nuclei. Acta Neurol Scand: 2011: 123: 424–429. © 2010 John Wiley & Sons A/S.

Background –  No previous study prospectively investigated the effects of subthalamic deep brain stimulation on fear of falling (FOF) and falls.

Aim –  The aim was to prospectively explore whether FOF and fall rate were affected after STN stimulation in people with Parkinson’s disease (PD).

Methods –  Twenty participants (mean age: 65 , SD 6.4) were included. Falls and near falls were recorded (fall diary) during 3 months before and 1 year after surgery. FOF was evaluated using the Falls-Efficacy Scale, Swedish version, FES(S), and the modified Survey of Activities and Fear of Falling in the Elderly (SAFFE). Results– After surgery, the FES(S) scores of complex activities improved (= 0.026), i.e. median 34 (q1–q3, 26–50) vs 43 (32–55). SAFFE scores also improved (P = 0.007): median 25 (22–30) versus 22 (18–27). The rate of near falls decreased (P = 0.014). Nine participants reported no near falls. For the remaining ten participants, the median near fall rate decreased from 6 (3–17) to 2 (1–8). The rate of falls showed no significant (P > 0.3) difference.

Conclusions –  After surgery, fewer activities were avoided owing to the risk of falling, and fall-related self-efficacy had improved during complex activities. The rate of near falls decreased. The results cannot support any change in fall rate.