Session Information
Date: Monday, June 5, 2017
Session Title: Parkinsonism, MSA, PSP (Secondary and Parkinsonism-Plus)
Session Time: 1:45pm-3:15pm
Location: Exhibit Hall C
Objective: To study the effect of low frequency stimulation (LFS) on freezing of gait (FOG) in a progressive supranuclear palsy (PSP) patient with bilateral STN DBS placed elsewhere, which has not been reported before.
Background: The beneficial effect of LFS on FOG has been repeatedly reported in Parkinson disease (PD) patients with bilateral STN DBS. Though DBS is not indicated for PSP, there have been instances where PSP patients were initially misdiagnosed as PD and bilateral STN DBS were subsequently placed. FOG is a common symptom in PSP and does not respond well to medications. We don’t know whether or not LFS has beneficial effect on FOG compared to HFS of bilateral STN in PSP.
Methods: A patient with an 8-year history of “PD” s/p bilateral STN DBS came to us for the management of FOG, which was slightly worse at medication OFF as compared to ON state, under usual HFS. The exam and brain MRI supported the diagnosis of typical PSP, with loss of vertical eye movement, intact oculocephalic reflex, axial greater than appendicular rigidity, imbalance and midbrain atrophy with hummingbird sign. His parkinsonism had limited response to dopaminergic medications, as did his FOG under HFS.
Results: LFS (60Hz) significantly improved his FOG when compared to HFS (130Hz) as assessed repeatedly in a 5-month period, even with corresponding TEED adjustment.
Conclusions: This is the first report showing the beneficial effect of LFS compared to HFS on FOG in a PSP patient with bilateral STN DBS.
References: 1. Xie T, Vigil J, MacCracken E, Gasparaitis A, Young J, Kang W, Bernard J, Warnke P, Kang UJ. Low frequency stimulation of STN DBS reduces aspiration and freezing of gait in patients with PD. Neurology 2015; 84:415-420.
2. Xie T, Kang UJ, Kuo SH, Poulopoulos M, Greene P, Fahn S. Comparison of clinical features in pathologically confirmed PSP and MSA patients followed at a tertiary center. npj (nature publication journal) Parkinson’s Disease 2015;1:15007; doi:10.1038/npjparkd.2015.7.
To cite this abstract in AMA style:
T. Xie, M. Padmanaban. Effect of low frequency stimulation on freezing of gait in a PSP patient with bilateral STN DBS [abstract]. Mov Disord. 2017; 32 (suppl 2). https://www.mdsabstracts.org/abstract/effect-of-low-frequency-stimulation-on-freezing-of-gait-in-a-psp-patient-with-bilateral-stn-dbs/. Accessed October 31, 2026.« Back to 2017 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/effect-of-low-frequency-stimulation-on-freezing-of-gait-in-a-psp-patient-with-bilateral-stn-dbs/