Abstract
This study aims to investigate how the frequency settings of deep brain stimulation (DBS) targeting the subthalamic nucleus (STN) influence the motor symptoms of Parkinson’s disease (PD). Stimulation with frequencies less than 100 Hz (mostly 60 or 80 Hz) is considered low-frequency stimulation (LFS) and with frequencies greater than 100 Hz (mostly 130 or 150 Hz) is considered high-frequency stimulation (HFS). We conducted a comprehensive literature review and meta-analysis with a random-effect model. Ten studies with 132 patients were included in our analysis. The pooled results did not show significant differences in the total Unified Parkinson Disease Rating Scale part III (UPDRS-III) scores (mean effect, -1.50; p=0.19) or the rigidity subscore between HFS and LFS. Compared to LFS, HFS reduced the tremor subscore more in the medication-off condition (mean effect, 1.01; p=0.002), but not in the medication-on condition (mean effect, 0.01; p=0.92). LFS was more effective than HFS in reducing the akinesia subscore (mean effect, -1.68, p=0.003) and the time to complete the stand-walk-sit (SWS) test as well as the number of freezing of gait (FOG) (mean effect, -4.84; p<0.00001 and mean effect, -1.71; p=0.03). Our results suggest that HFS induces a better response for tremors, while LFS may induce a greater response for akinesia, gait, and FOG. These results provide optimized STN-DBS programs for different motor symptoms in PD.
Highlights
Parkinson’s disease (PD) is a neurodegenerative disorder, characterized by pathological motor symptoms including tremors, rigidity, bradykinesia and postural instability[1]
We retrieved full-text articles and found 24 studies that compared the acute effects of low- and high- frequency subthalamic nucleus (STN)-deep brain stimulation (DBS) on motor symptoms in PD
By analyzing the acute effects of low-frequency stimulation (LFS) and high-frequency stimulation (HFS) in STN-DBS on the motor symptoms of patients with PD, our results demonstrated that HFS alleviates tremors better than LFS in the medication-off state, but not in the medication-on state, which is probably due to ceiling-effects on the improvement of tremor in the medication-on state
Summary
Parkinson’s disease (PD) is a neurodegenerative disorder, characterized by pathological motor symptoms including tremors, rigidity, bradykinesia and postural instability[1]. Previous studies showed that STN-DBS can improve the functional performance of PD patients as evidenced by a 25% decrease in the Unified Parkinson Disease Rating Scale part III (UPDRS-III) scores, a 25% decrease in the average levodopa-equivalent daily dose (LEDD) and an 80% decrease in drug-induced dyskinesia[6]. The frequency of DBS is often categorized as high frequency (i.e., HFS, >100 Hz, mostly 130 or 150 Hz) or low frequency (i.e., LFS,
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
