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

Mov Disord. 2014 Feb;29(2):270-4. doi: 10.1002/mds.25810. Epub 2014 Jan 21.

Abstract

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.

Keywords: Parkinson's disease; deep brain stimulation; low-frequency stimulation; motor function; subthalamic nucleus.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biophysics
  • Cross-Over Studies
  • Deep Brain Stimulation / methods*
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Outcome Assessment, Health Care
  • Parkinson Disease / therapy*
  • Statistics, Nonparametric
  • Subthalamic Nucleus / physiology*