Low-Frequency Deep Brain Stimulation Improves Parkinson's Symptoms

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Low-frequency bilateral subthalamic nucleus deep brain stimulation is more effective for improving swallowing function and freezing of gait in people with Parkinson's disease compared to routine 130 Hz stimulation, according to a new study published in Neurology.

Swallowing dysfunction and freezing of gait are difficult to treat with medication and routine high-frequency deep brain stimulation, and often leading to greater disability and early death.

Researchers from the University of Chicago Medicine and Columbia University Medical Center evaluated seven patients with Parkinson's disease (PD) that experienced persistent freezing of gait (FOG) despite 130 Hz deep brain stimulation (DBS) and dopaminergic therapy. Compared to the 130 Hz stimulation, the 60 Hz stimulation significantly improved swallowing function, FOG, as well as axial and parkinsonian symptoms. The effects persisted over the course of the six-week assessment, reported Tao Xie, MD, PhD, of the University of Chicago Medicine, and colleagues.

All patients received three modified barium swallow studies in one day under three DBS conditions during the medication-on state: 130 Hz, 60 Hz, or DBS off. The patients completed a swallowing questionnaire, and were assessed via the Unified Parkinson's Disease Rating Scale, Part III motor score, axial subscore, tremor subscore, and FOG by a questionnaire and stand-walk-sit test.

Compared with routine 130 Hz DBS, 60 Hz DBS reduced aspiration frequency by 57% on modified barium swallow studies and reduced perceived swallowing difficulty by 80% on the questionnaire. Researchers also observed a reduction in FOG and axial and parkinsonian symptoms. 

"This is the first study to successfully treat swallowing dysfunction, and one of the first to treat difficulty with gait, using this unusual low-frequency 60 hertz stimulation,” said Xie, according to Medical News Today.

The researchers hope that the study results will help improve quality of care for people with Parkinson's disease and perhaps even reduce disease severity. 

Reference

  1. Xie T et al. Neurology. 2015; doi:10.1212/WNL.0000000000001184.
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