Low‐frequency subthalamic nucleus stimulation in Parkinson's disease: a randomized clinical trial

HM Khoo, H Kishima, K Hosomi, T Maruo… - Movement …, 2014 - Wiley Online Library
HM Khoo, H Kishima, K Hosomi, T Maruo, N Tani, S Oshino, T Shimokawa, M Yokoe…
Movement disorders, 2014Wiley Online Library
Background Low‐frequency, bilateral stimulation of the subthalamic nucleus can improve
axial symptoms of advanced Parkinson's disease (PD), but it is not particularly effective for
segmental symptoms. Methods The optimal contacts for low‐frequency (60 Hz) and high‐
frequency (130 Hz) single monopolar stimulation were determined. Then, in a randomized,
double‐blind, prospective crossover manner, 60‐Hz and 130‐Hz stimulations via the
respective optimal contacts were compared for immediate efficacy in improving the motor …
Background
Low‐frequency, bilateral stimulation of the subthalamic nucleus can improve axial symptoms of advanced Parkinson's disease (PD), but it is not particularly effective for segmental symptoms.
Methods
The optimal contacts for low‐frequency (60 Hz) and high‐frequency (130 Hz) single monopolar stimulation were determined. Then, in a randomized, double‐blind, prospective crossover manner, 60‐Hz and 130‐Hz stimulations via the respective optimal contacts were compared for immediate efficacy in improving the motor function of patients with PD.
Results
The optimal contacts for 60‐Hz stimulation were situated more ventrally than those for 130‐Hz stimulation (P = 0.038). Under the respective optimal, single monopolar stimulation, 60 Hz provided superior efficacy over 130 Hz in improving the total Unified Parkinson's Disease Rating Scale motor score (P < 0.001) and the akinesia (P = 0.011) and axial motor signs (P = 0.012) subscores without compromising the therapeutic effect on tremor and rigidity.
Conclusions
Low‐frequency stimulation via the optimal contacts is effective in improving overall motor function of patients with PD. © 2014 International Parkinson and Movement Disorder Society
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