Surgical Treatment of PD
Moreau C, Defebvre L, Destée A, Bleuse S, Clement F, Blatt JL, Krystkowiak P, Devos D. (2008) Surgical Treatment of PD , STN-DBS frequency effects on freezing of gait in advanced Parkinson disease. Neurology. 2008 Apr 16 [Epub ahead of print]
The purpose of this study was to look at the parameters of DBS-STN settings when PWP have severe gait disturbance or episodes of freezing. The goal of this study was to evaluate if making setting changes would reduce such disturbances. All of the patients who participated had undergone DBS STN within 5 years of the worsening of their motor difficulties and had experienced initial improvement after the surgery. The results of this study suggested that a two step approach to the stimulation parameters may be the best method for controlling the severe gait disturbances and freezing episodes that can be seen in advanced Parkinson’s disease. They suggested that initially a higher stimulator frequency setting (130 Hz) is beneficial with “typical voltage” for optimal motor control but after motor disturbances worsen with time a lower stimulator frequency setting (60 Hz) with higher voltage may show more promise. The authors also offered multiple hypotheses as to why such stimulator changes may be beneficial (e.g. surrounding structures, changes in the STN with disease progression). Further research on stimulator settings was recommended to fully evaluate this treatment option’s efficacy for controlling motor dysfunction in PWP.