Session Information
Date: Monday, June 5, 2017
Session Title: Surgical Therapy: Parkinson’s Disease
Session Time: 1:45pm-3:15pm
Location: Exhibit Hall C
Objective: To compare the efficacy and tolerability of low-frequency stimulation (LFS) during daytime only to LFS applied 24 hours a day, in PD patients bilaterally implanted for subthalamic nucleus deep brain stimulation (STN-DBS) who develop drug- and stimulation-resistant freezing of gait (FOG).
Background: High-frequency electrical stimulation (HFS) of the STN, typically in the range of 130 – 185 Hz, is an effective procedure to treat parkinsonian symptoms such as tremor, bradykinesia and rigidity. Nevertheless, in the long term a number of patients develop gait disturbances, especially FOG, that is poorly responsive to HFS and/or dopaminergic treatment. Several studies reported that LFS (typically 60 – 80 Hz) could be useful to improve gait disturbances and FOG. However, not all patients tolerate LFS well due to worsening of motor symptoms, and need to return to conventional HFS.
Methods: Prospective, randomized, cross-over, double-blind study of PD patients treated with STN-DBS at conventional HFS for at least 12 months, who developed disabling FOG (FOG-questionnaire item 3 > 3). Patients will be randomized in two groups: one group will receive continuous LFS (60 Hz) 24 hours a day while the second group will receive LFS only during daytime and switched back to 130 Hz during the night. After one month, the two groups will be crossed over. Neurological evaluations will be performed at the time of study entry, and repeated after one and two months. Patients and neurologists involved in the clinical evaluation will be unaware of the stimulation settings.
Results: The study will evaluate the efficacy of LFS on disabling FOG and establish whether LFS applied only during the daytime reduces the number of patients who need to return to HFS due to worsening of motor symptoms.
Conclusions: This study explores the possible role of neuroplasticity mechanisms in conditioning changes in clinical response to continuous DBS. Furthermore, it could help to better understand the relation between variations of stimulation frequency and improvement of freezing of gait during STN-DBS.
To cite this abstract in AMA style:
F. Dematteis, M. Zibetti, E. Montanaro, L. Rizzi, M. Lanotte, L. Lopiano, M. Rizzone. Efficacy and tolerability of low-frequency deep brain stimulation during daytime only in Parkinson’s disease: a pilot study [abstract]. Mov Disord. 2017; 32 (suppl 2). https://www.mdsabstracts.org/abstract/efficacy-and-tolerability-of-low-frequency-deep-brain-stimulation-during-daytime-only-in-parkinsons-disease-a-pilot-study/. Accessed November 22, 2024.« Back to 2017 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/efficacy-and-tolerability-of-low-frequency-deep-brain-stimulation-during-daytime-only-in-parkinsons-disease-a-pilot-study/