Objective: To quantitatively evaluate the effect of variable DBS frequencies on static postural control in Parkinson’s disease (PD) patients with Bilateral STN or GPi stimulators by employing force plate.

Background: Impairment of static postural control is one of the major contributory factors causing falls in PD patients. In this study we quantitatively measured the effect of low (LF-30 Hz), intermediate (IF-80 Hz) and high (HF >120 Hz) DBS frequencies in patients with bilateral STN and GPi simulators using a force plate.

Methods: We tested 13 patients (7 bilateral STN and 6 Bilateral GPi). They were evaluated at HF, IF, and LF conditions in medication-off state in eyes open and eyes closed condition. IF and LF conditions were selected randomly. A minimum of 30-minute wait period was allowed before evaluation after changing stimulation frequency. All patients were examined at all frequencies using MDS-UPDRS. Among the postural control parameters; Sway AP (sway in anteroposterior direction), Sway ML (sway in mediolateral direction), area of ellipse (total area of postural sway), MPF_AP (mean Power frequency in anteroposterior direction), MPF_ML (mean Power frequency in mediolateral direction), RMS_AP (root mean square anteroposterior) and RMS_ML (root mean square in mediolateral) were calculated.

Results: Data was analyzed using MANOVA (p= 0.0041, Table 1)). At 120 Hz frequency UPDRS scores were better (29) when compared to IF (31) and LF (34). Among the UPDRS motor subsets at HF, arising from chair (0.52 vs 0.57 vs 0.63), gait (1.00 vs 1.23 vs 1.46), posture (1.42 vs 1.72 vs 1.77) and bradykinesia (1.65 vs 1.88 vs 2.06) were significantly improved.. Area of ellipse was significantly lower at HF (422 mm2) vs IF (581 mm2) and LF (509 mm2). Mediolateral Sway (17mm vs 22 vs 19 mm), mean velocity (18 mm/sec vs 16.8 mm/sec vs 16 mm/sec), mean power frequency in anteroposterior (0.26 Hz vs 0.24 Hz vs 0.22 Hz) and mediolateral directions (0.27 Hz vs 0.24 Hz vs 0.21 Hz) and root mean square in mediolateral direction (3.22 mm vs 3.79 mm vs 3.69 mm) were significantly improved when compared with IF and LF.

Conclusions: Our results indicate that HF (> 120 Hz) improved static postural control when compared with IF and LF. This suggests that HF stimulation may be more likely to lessen falls.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/measurement-of-effect-of-variable-deep-brain-stimulation-dbs-frequencies-on-static-postural-control-in-parkinsons-disease-pd-patients-with-bilateral-stn-or-gpi-stimulators-by-employing-force-plat/