Objective: 1) To describe the evolution of FOG in a large cohort of patients at 1 year postoperatively from bilateral STN-DBS in PD. 2) To search for clinical and radiological preoperative predictive factors of FOG evolution.

Background: Effects of subthalamic nucleus-deep brain stimulation (STN-DBS) on freezing of gait
(FOG) in Parkinson’s disease (PD) are still unclear and predictive factors of evolution are missing.

Method: Data from question 4 of FOG questionnaire of 329 patients from the French national study PREDISTIM were collected pre-operatively (V0) and one year after surgery (V1). Four groups of evolution were created: one worsening, one stable without FOG, one stable with FOG and one improving. These groups were compared at V0 for clinical and radiological variables (including cortical thickness analysis, volumes, shape and grey matter intensity of selected basal ganglia).

Results: At V0, 222 (68%) of patients were freezers versus 202 (61%) at V1. After 1 year, 73 (22%) patients worsened their FOG, 135 (41%) were stable, and 121 (37%) improved their FOG. A tendency to cortical thickening in the group worsening their FOG compared to the group improving their FOG has been demonstrated. A gradient of gray matter intensity in T1 sequence was also demonstrated at the level of the 2 thalami between the 4 groups.

Conclusion: The impact of STN DBS on FOG varies according to subtypes of patients but seems favorable in 78% of cases for early doparesponsive FOG. The ventral attentional network, involving the right TPOJ3, may be involved in the FOG progression.

« Back to 2022 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/structural-mri-prediction-of-freezing-of-gait-in-parkinsons-disease-after-deep-brain-stimulation/