Session Information
Date: Monday, June 20, 2016
Session Title: Surgical therapy: Parkinson's disease
Session Time: 12:30pm-2:00pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To compare the effect of variable Deep brain Stimulation (DBS) frequencies on gait and balance in Parkinson’s disease (PD) patients with either bilateral GPi or STN stimulators employing wearable wireless sensors.
Background: Gait and balance abnormalities are major problems in PD patients. In this study we quantitatively studied the effect of low (LF-30 Hz), intermediate (IF-80 Hz) and high DBS frequency (HF >120 Hz) on gait and balance using wearable wireless sensors.
Methods: We tested 17 patients (8 bilateral STN and 9 bilateral GPi) employing wearable wireless sensors. Subjects were first tested in their usual HF DBS settings. They were reevaluated at IF, and LF conditions in medication-off state after random selection of the sequence of IF and LF. A minimum of 30-minute wait period was allowed before evaluation after changing frequencies. All Patients were examined at all frequencies using MDS-UPDRS. Among the gait parameters, UPDRS motor scores, Duration of gait cycle, Stride length (length of step from heel to heel), Stride velocity, cadence (number of steps/minute), double support (both feet in contact with ground), gait swing (reference limb not on the ground), stance (reference limb in contact with ground), peak shank and arm swing velocity and range of motion of arms were tested.
Results: Data was analyzed using MANOVA (p value= .01930, table 1). Motor part of UPDRS score was improved at HF (29) when compared with IF (31) and LF (37). Among the UPDRS motor subtests at HF, arising from chair (0.5 vs 0.58 vs 0.58), gait (1 vs 1.27 vs 1.48), posture (1.41 vs 1.75 vs 1.80) and bradykinesia (1.67 vs 1.95 vs 2.11) were significantly improved as compared to IF and LF. At HF; stride length measured in terms of % of subject height (76 vs 74 vs 75), Peak arm swing velocity (160 degrees/ sec vs 151 degrees/ sec vs 135 degrees/ sec) and Range of motion arm (20 degrees vs 18 degrees vs 17 degrees) were significantly improved. There were no significant difference between stride velocity, duration of gait cycle, cadence, double support, stance, gait swing and peak shank velocity among HF, IF and LF.
| Frequency | HF (>120Hz) | IF (80 Hz) | LF (30 Hz) | Multivariate Analysis of Variance Results (MANOVA) |
|---|---|---|---|---|
| UPDRS SCORE ( motor part) | 29.04* | 31.46 | 37.06 | Wilks Lambda= .65733 |
| Duration of gait cycle (seconds) | 38.75 | 38.08 | 38.84 | F(20, 162)= 1.8906 |
| Stride Length/ length of step from heel to heel ( % of subjects height) | 76.49* | 74.04 | 75.63 | p= .01615 |
| Stride Velocity/ Walking Speed( % of subjects height/sec) | 71.87 | 72.40 | 70.84 | * significant |
| Cadence (number of steps/min) | 112.97 | 112.92 | 112.54 | |
| Double Support/ Both Feet in contact with ground ( % of gait cycle time) | 21.63 | 21.18 | 21.62 | |
| Gait Swing/ Reference limb not on ground( % of gait cycle time) | 39.20 | 39.39 | 39.16 | |
| Stance/ Reference limb in contact with ground ( % of gait cycle time) | 60.81 | 60.59 | 60.81 | |
| Peak Shank Velocity ( Degrees/seconds) | 361.62 | 364.41 | 352.50 | |
| Peak Arm Swing Velocity (Degrees/seconds) | 160.38* | 151.01 | 135.87 | |
| RoM Arms/ Range of motion of arms (Degrees) | 20.34* | 18.88 | 17.40 |
Conclusions: Overall HF improved some gait and balance parameters when compared with IF and LF. This improvement in these parameters may translate into a decrease in falls.
To cite this abstract in AMA style:
A. Deep, A. Lieberman, R. Dhall, T. Lockhart, C. Frames, S. Shafer, N. Tateuchi, E. Simpson, M. McCauley, N. Krishnamurthi. Comparison of effect of variable deep brain stimulation (DBS) frequencies on gait and balance in Parkinson’s disease (PD) patients with either bilateral GPi or STN stimulators employing wearable wireless sensors [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/comparison-of-effect-of-variable-deep-brain-stimulation-dbs-frequencies-on-gait-and-balance-in-parkinsons-disease-pd-patients-with-either-bilateral-gpi-or-stn-stimulators-employing-wearable-wirel/. Accessed November 22, 2024.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/comparison-of-effect-of-variable-deep-brain-stimulation-dbs-frequencies-on-gait-and-balance-in-parkinsons-disease-pd-patients-with-either-bilateral-gpi-or-stn-stimulators-employing-wearable-wirel/