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Subthalamic deep brain stimulation at individualized frequencies for Parkinson disease
Neurology, 07/02/2012
Clinical Article
Tsang EW et al. – The study provides Class III evidence that subthalamic nucleus (STN) deep brain stimulation (DBS) at patient–specific γ frequencies and at usual high frequencies both improved motor Unified Parkinson's Disease Rating Scale (mUPDRS) scores compared to no stimulation and did not differ in effect.
Methods- The authors prospectively studied 13 patients with PD.
- STN local field potential (LFP) was recorded after electrode implantations, in the OFF and then in ON dopaminergic medication states while patients performed wrist movements.
- Six individual peak frequencies of the STN LFP power spectra were obtained: the greatest decrease in θ and β and greatest increase in γ frequencies in the ON state (MED) and during movements (MOVE).
- Eight DBS frequencies were applied including 6 MED and MOVE frequencies, high frequency (HF) used for chronic stimulation, and no stimulation.
- The patients were assessed using the motor Unified Parkinson's Disease Rating Scale (mUPDRS).
- STN DBS at γ frequencies (MED and MOVE) and HF significantly improved mUPDRS scores compared to no stimulation and both γ frequencies were not different from HF.
- DBS at θ and β frequencies did not worsen mUPDRS scores compared to no stimulation.