Long-term effect of low frequency stimulation of STN on dysphagia, freezing of gait and other motor symptoms in PD

ObjectiveTo evaluate the long-term effect of 60 Hz stimulation of the subthalamic nucleus (STN) on dysphagia, freezing of gait (FOG) and other motor symptoms in patients with Parkinson’s disease (PD) who have FOG at the usual 130 Hz stimulation.MethodsThis is a prospective, sequence randomised, cros...

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Vydáno v:Journal of neurology, neurosurgery and psychiatry Ročník 89; číslo 9; s. 989 - 994
Hlavní autoři: Xie, Tao, Bloom, Lisa, Padmanaban, Mahesh, Bertacchi, Breanna, Kang, Wenjun, MacCracken, Ellen, Dachman, Abraham, Vigil, Julie, Satzer, David, Zadikoff, Cindy, Markopoulou, Katerina, Warnke, Peter, Kang, Un Jung
Médium: Journal Article
Jazyk:angličtina
Vydáno: England BMJ Publishing Group LTD 01.09.2018
Témata:
Aged
Cross-Over Studies
Deep Brain Stimulation
Deglutition Disorders - etiology
Deglutition Disorders - therapy
Double-Blind Method
Dysphagia
Female
Gait
Gait Disorders, Neurologic - etiology
Gait Disorders, Neurologic - therapy
Humans
Male
Middle Aged
Neurology
Parkinson Disease - complications
Parkinson Disease - therapy
Parkinson's disease
Patients
Prospective Studies
Subthalamic Nucleus
Time Factors
Treatment Outcome
DBS
freezing
gait
dysphagia
STN
Parkinson’s disease
frequency
ISSN:0022-3050, 1468-330X, 1468-330X
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Shrnutí:ObjectiveTo evaluate the long-term effect of 60 Hz stimulation of the subthalamic nucleus (STN) on dysphagia, freezing of gait (FOG) and other motor symptoms in patients with Parkinson’s disease (PD) who have FOG at the usual 130 Hz stimulation.MethodsThis is a prospective, sequence randomised, crossover, double-blind study. PD patients with medication refractory FOG at 130 Hz stimulation of the STN were randomised to the sequences of 130 Hz, 60 Hz or deep brain stimulation off to assess swallowing function (videofluoroscopic evaluation and swallowing questionnaire), FOG severity (stand–walk–sit test and FOG questionnaire) and motor function (Unified PD Rating Scale, Part III motor examination (UPDRS-III)) at initial visit (V1) and follow-up visit (V2, after being on 60 Hz stimulation for an average of 14.5 months), in their usual medications on state. The frequency of aspiration events, perceived swallowing difficulty and FOG severity at 60 Hz compared with 130 Hz stimulation at V2, and their corresponding changes at V2 compared with V1 at 60 Hz were set as primary outcomes, with similar comparisons in UPDRS-III and its subscores as secondary outcomes.ResultsAll 11 enrolled participants completed V1 and 10 completed V2. We found the benefits of 60 Hz stimulation compared with 130 Hz in reducing aspiration frequency, perceived swallowing difficulty, FOG severity, bradykinesia and overall axial and motor symptoms at V1 and persistent benefits on all of them except dysphagia at V2, with overall decreasing efficacy when comparing V2 to V1.ConclusionsThe 60 Hz stimulation, when compared with 130 Hz, has long-term benefits on reducing FOG, bradykinesia and overall axial and motor symptoms except dysphagia, although the overall benefits decrease with long-term use.Clinical trial registration NCT02549859; Pre-results.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:0022-3050
1468-330X
1468-330X
DOI:10.1136/jnnp-2018-318060