Objective: Evaluate the effect of SNr stimulation on freezing of gait and analyse changes in local field potentials. We describe an early-onset Parkinson´s disease patient with a mutation in Parkin gene.

Background: Subthalamic deep brain stimulation may improve gait in some cases. Recent studies have shown that nigral stimulation may improve gait in PD freezers when added to standard subthalamic deep brain stimulation.

Methods: The treatment consists of a combination of subthalamic nucleus stimulation and substantia nigra pars reticulate stimulation, using the most ventral contact of the electrode, located in a caudal position. Microrecording and image analysis was used to determine the activity in the different regions.

Results: Primary outcome measured was a change in motor symptoms with an improvement of the gait. However, a significant change in behavior with irritability and disinhibition was developed after deep brain stimulation. After switch-off the subthalamic stimulation an improvement in character without worsening in gait was observed.

Conclusions: Stimulation on nigral contacts additional to subthalamic stimulation will imporove therapuetic effect, specifically freezing of gait. However, ventral stimulation of the subthalamic nucleus may induce changes in behaviour.

References: Nigral stimulation for resistant axial motor impairment in Parkinson’s disease? A randomized controlled trial. Weiss D, Walach M, Meisner C, Fritz M, Scholten M, Breit S, Plewnia C, Bender B, Gharabaghi A, Wächter T, Krüger R. Brain. 2013 Jul;136(Pt 7):2098-108. doi: 10.1093/brain/awt122. Epub 2013 Jun 11.

« Back to 2018 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/nigral-stimulation-for-the-treatment-of-refractory-gait-disturbances-in-parkinsons-disease/