Low-frequency Subthalamic Stimulation in Parkinson's Disease: Long-term Outcome and Predictors

Brain Stimulation

Renato P. Munhoz¹  Maurizio Zibetti²  Francesco Sammartino³  Vibhor Krishna³  Alfonso Fasano³  Marina Picillo⁴  Andres M. Lozano⁴  Elena Moro⁵ 

[1] Centre for Neurodegenerative Diseases (CEMAND), Department of Medicine and Surgery, University of Salerno, Salerno, Italy;Department of Neuroscience “Rita Levi Montalcini”, University of Torino, Torino, Italy;Division of Neurosurgery, Toronto Western Hospital – UHN, University of Toronto, Toronto, Ontario, Canada;Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital – UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada;Service de Neurologie, CHU Grenoble, Joseph Fourier University, INSERM U836, Grenoble, France;

关键词: Parkinson's disease;    Surgery;    Deep brain stimulation;    Subthalamic nucleus;    Low-frequency stimulation;   

DOI  :  

来源: DOAJ

【 摘 要 】

Background: Parkinson's disease patients undergoing subthalamic nucleus deep brain stimulation (STN DBS) at standard frequency (>100 Hz) often develop gait impairment, postural instability and speech difficulties. Low frequency stimulation (<100 Hz, LFS) can improve such axial symptoms, but there are concerns that improvement may be transient. Objective: To identify long-term outcome and predictors of low-frequency subthalamic stimulation in Parkinson's disease. Methods: Through a chart review we identified 85 out of 324 STN DBS patients who received a trial of LFS and describe their characteristics and outcome predictors. Results: Patients were switched to LFS (<100 Hz) 3.8 ± 3.3 years after surgery. Most patients (64%) attained a subjective improvement of gait, speech or balance for 2.0 ± 1.9 years. Motor scores improved within the first year after the stimulation change and showed a slower progression over time when compared to patients switched back to high frequency stimulation. UPDRS III axial score on medication before surgery and the y-axis coordinate of the active contact were independent predictors of LFS retention. Conclusions: This report provides evidence that the use of LFS yields an enduring benefit in a considerable percentage of patients who develop axial motor symptoms during conventional stimulation.

【 授权许可】

Unknown