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Objective <p>We investigated the effects of Subthalamic Deep Brain Stimulation (STN-DBS) at high (180hz) and low frequency (60hz) and L-dopa on variability of spatiotemporal gait measures in an advanced PD cohort.</p> Materials and methods <p>This study consisted of PD subjects with chronic bilateral STN-DBS. Each combination of medication state (OFF/ON) and stimulation frequency (60&#xa0;Hz/180Hz) were assessed and randomized across electrode contacts. Instrumented stand and walk tests were performed for each stimulation-medication condition and coefficient of variance (CV) was computed for each lower limb gait parameter. LM-ANOVA was employed for analysis.</p> Results <p>Twenty-two PD subjects with chronic DBS were recruited with an average age of 63.9(SD 9) years. L-dopa reduced variability in both spatial and temporal gait parameters: cadence (L/R, <i>p</i> &lt; 0.0001), gait speed (L/R, <i>p</i> &lt; 0.0001), toe off angle (L/R, <i>p</i> &lt; 0.0001), SLS (L, <i>p</i> = 0.0002; R, <i>p</i> = 0.001), stance (L, <i>p</i> = 0.01, R, <i>p</i> &lt; 0.0001;), step duration (L, <i>p</i> &lt; 0.0001; R, <i>p</i> = 0.004), stride length (L/R, <i>p</i> &lt; 0.0001), and foot swing (L, <i>p</i> = 0.0003; R, <i>p</i> &lt; 0.0001). Low and high frequency DBS reduced variability in cadence, foot elevation midswing, speed, right foot strike angle, SLS, stand, step duration, stride length, and foot swing. 60&#xa0;Hz STN-DBS synergistically reduced left foot mid-swing elevation variability (<i>p</i> = 0.02) when combined with medication.</p> Conclusion <p>This study demonstrates significant reduction in variability of spatial and temporal gait measures from L-dopa and STN-DBS. It further reveals a synergistic effect of 60Hz STN-DBS with L-dopa in reducing foot elevation midswing variability.</p>

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Sixty hertz STN-DBS and L-Dopa reduces gait variability in parkinson’s disease

  • 期刊论文

  • 发表日期：

    2025年2月20日

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  • Ritesh A. Ramdhani,
  • Myriam Kline,
  • Shahidul Islam,
  • Toni Fitzpatrick,
  • Anahita Khojandi

摘要

Objective

We investigated the effects of Subthalamic Deep Brain Stimulation (STN-DBS) at high (180hz) and low frequency (60hz) and L-dopa on variability of spatiotemporal gait measures in an advanced PD cohort.

Materials and methods

This study consisted of PD subjects with chronic bilateral STN-DBS. Each combination of medication state (OFF/ON) and stimulation frequency (60 Hz/180Hz) were assessed and randomized across electrode contacts. Instrumented stand and walk tests were performed for each stimulation-medication condition and coefficient of variance (CV) was computed for each lower limb gait parameter. LM-ANOVA was employed for analysis.

Results

Twenty-two PD subjects with chronic DBS were recruited with an average age of 63.9(SD 9) years. L-dopa reduced variability in both spatial and temporal gait parameters: cadence (L/R, p < 0.0001), gait speed (L/R, p < 0.0001), toe off angle (L/R, p < 0.0001), SLS (L, p = 0.0002; R, p = 0.001), stance (L, p = 0.01, R, p < 0.0001;), step duration (L, p < 0.0001; R, p = 0.004), stride length (L/R, p < 0.0001), and foot swing (L, p = 0.0003; R, p < 0.0001). Low and high frequency DBS reduced variability in cadence, foot elevation midswing, speed, right foot strike angle, SLS, stand, step duration, stride length, and foot swing. 60 Hz STN-DBS synergistically reduced left foot mid-swing elevation variability (p = 0.02) when combined with medication.

Conclusion

This study demonstrates significant reduction in variability of spatial and temporal gait measures from L-dopa and STN-DBS. It further reveals a synergistic effect of 60Hz STN-DBS with L-dopa in reducing foot elevation midswing variability.