Objective: Objectives: To determine whether Deep Brain Stimulation on the Subthalamic nucleus (STN-DBS) is responsible for post-surgery de novo On-State Freezing-of-Gait (FOG) in PD patients, and to measure the extent to which FOG is modulated by different stimulation frequencies.

Background: The beneficial effects of DBS-STN on FOG is controversial. The presence of FOG on ON-state (ON-FOG) after STN-DBS has been attributed both to disease progression or stimulation induced side-effect.

Method: 17 PD patients with STN-DBS and FOG in the MedON/StimON condition were evaluated in five conditions: MedOFF/StimOFF, MedOFF/StimON, MedON/StimOFF, MedON/StimON (130 Hz and 60 Hz). Inertial measurement units (IMUs) were employed to characterize gait and FOG, complementing clinical assessment in a more robust and extensive way.

Results: The incidence and duration (% time) of FOG during the gait task was significantly higher OFF stimulation and medication (61.51 ± 41.20 OFF/OFF vs 32.09 ± 24.43 ON/ON, p = 0.03). Stimulation alone could account for the majority of the observed rescuing (38.29 ± 38.61 OFF/ON vs 61.51 ± 41.20 OFF/OFF, p = 0.02). No significant differences were observed across stimulation frequencies (32.09 ± 24.41 @ 130 Hz vs 32.39 ± 26.69 @ 60 Hz, p = 0.95). At a kinematic level, the improvements observed ON stimulation were accompanied by increased step length, reduced step variability and an increased proportion of the gait cycle spent on single support.

Conclusion: FOG and overall gait quality were significantly worsened with the stimulation turned OFF, supporting that the On-state FOG observed after surgery is not a mere surgery/stimulation consequence. The severity of FOG was not significantly altered by changing stimulation frequencies.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/unveiling-the-role-of-subthalamic-nucleus-stimulation-on-freezing-of-gait-in-parkinson-disease-using-wearable-sensors/