Low-Frequency Adaptive Deep Brain Stimulation for Parkinson's Disease.

Area of Science:

• Neuroscience
• Neurology
• Biomedical Engineering

Background:

• Freezing of gait (FOG) is a progressive and debilitating Parkinson's disease (PD) symptom.
• Adaptive deep brain stimulation (aDBS) shows promise for managing fluctuating PD symptoms.
• Low-frequency stimulation (LFS) may offer additional gait benefits in moderate-to-advanced PD.

Purpose of the Study:

• To evaluate the efficacy of 60 Hz continuous deep brain stimulation (cDBS).
• To assess the safety, tolerability, and feasibility of 60 Hz adaptive deep brain stimulation (aDBS).

Main Methods:

• Eight individuals with PD received bilateral subthalamic nucleus leads and the Summit RC+S system.
• 60 Hz aDBS was calibrated to adjust stimulation based on beta bursts.
• Participants underwent blinded, randomized testing during a FOG-eliciting task under OFF DBS, 60 Hz cDBS, and 60 Hz aDBS.

Main Results:

• 60 Hz cDBS was tolerated by 6/8 participants and reduced beta burst duration.
• 60 Hz aDBS was safe and tolerable.
• Gait improved in participants with baseline FOG during both 60 Hz aDBS and cDBS.

Conclusions:

• 60 Hz aDBS and cDBS benefit PD patients with baseline FOG.
• These LFS protocols may not provide broad motor symptom relief compared to high-frequency stimulation (HFS).
• Personalized DBS programming by identifying LFS responders is crucial.