Objective: To investigate the effect of Multiple Independent Current Control (MICC) on gait of Parkinson’s Disease (PD)

Background: Classical programming with the ring and segmented contacts is not effective enough to control the gait disorders in some of the PD patients. The MICC technology gives us an opportunity to try different frequencies in distinct contacts. In a limited number of studies conducted with MICC, positive effects on motor findings, drug dose reduction and quality of life have been reported. The data is limited for gait disorders.

Method: This study included 448 PD patients who underwent bilateral subthalamic nucleus DBS between January 2022 and December 2024. Data were collected retrospectively. The UPDRS motor scores were evaluated preoperatively and postoperatively. The programming parameters of 34 patients who had gait disorders (freezing of gait, postural instability) within the 1st month after the operation were recorded. Since the symptoms did not improve with classical programming, we preferred MICC.

Results: The mean age of the patients was 61.35 years. The UPDRS motor scores of the patients improved 72% at the end of 4 weeks of programming. The most ventral contacts were activated bilaterally with a frequency of 50-60 Hz, amplitude of 0.5 mA and a pulse width of 60 μs. The dorsal contacts were activated with higher frequency (119-185 Hz), higher amplitude (1.3-4.0 mA) and a pulse width of 60 μs. Although the gait disorders improved with MICC in one month, 19 of these patients were switched back to classical programming by deactivating the ventral contacts because of walking difficulty during follow-up.

Conclusion: According to the previous studies, both low and high frequencies with classical programming can be beneficial for gait control. In a study conducted with 28 PD patients examining the effects of programming at variable frequencies (60-80/130-185 Hz) on the same electrode, it was observed that there was a significant improvement of freezing of gait at the end of 12-month. In our study, although the motor symptoms like tremor, bradykinesia, tremor resolved by classical programming, 7.5% of the patients required MICC programming due to early postoperative gait problems. However, by time in 56% of the patients, the ventral contacts preferred in MICC were switched off because of severe bradykinesia in the lower extremities, probably due to chronic stimulation of substansia nigra.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/multiple-independent-current-control-for-gait-disorders-in-early-programming-of-parkinsons-disease/