Objective: Parkinson’s disease patients who have undergone deep brain stimulation ( DBS) having freezing of gait do not show improvement with high frequency stimulation ( 130hz). To see if low frequency stimulation (upto 50 hz) improves the gait in these patients.

Background: High frequency (130 Hz) Deep Brain stimulation of subthalamic nucleus has produced significant benefits in patients with tremor predominant PD. Patients with significant gait disturbance and freezing of gait do not improve with high frequency. Low frequency (up to 50 Hz) stimulation has found to be beneficial in improving the gait. Our experience in treating 26 patients in the past 5 years is discussed.

Methods: 26 patients with advanced Parkinson’s disease in the past three years who underwent bilateral subthalamic stimulation and in whom freezing of gait was an issue were analysed. The effect on gait with high frequency versus low frequency was assessed using axial sub score (Part III) of   MDS UPDRS.

Results: There was significant improvement in gait in all our patients who were on low frequency stimulation in both on and off periods. No major side effect was noted.

Conclusions:  Low frequency Deep Brain stimulation helps in improving the gait and axial symptoms in Parkinson’s disease patients.

References:  

1.Khoo HM et al. Low-frequency subthalamic nucleus stimulation in Parkinson’s disease: A randomized clinical trial. Movement disorder 2014 Jan;21 (Epub ahead of print)

2.Sidiropoulus C , Xie T et al. Low-frequency subthalamic nucleus deep brain stimulation for axial symptoms in advanced Parkinson’s disease. Journal of Neurology 2015. Aug 11;85(6) : 557

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MDS Abstracts - https://www.mdsabstracts.org/abstract/low-frequency-deep-brain-stimulation-for-parkinsons-disease-effect-on-freezing-of-gait/