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The Effect of Dual Tasking and Deep Brain Stimulation Frequency Parameters on Gait in Advanced Parkinson's Disease.
Annals of Indian Academy of Neurology ( IF 1.7 ) Pub Date : 2020-05-01 , DOI: 10.4103/aian.aian_11_19 Swetha Tandra 1 , Rukmini M Kandadai 1 , Ravi P Peddisetty 2 , K J Babu 1 , T Surya Prabha 1 , S A Jabeen 1 , A K Meena 1 , Rupam Borgohain 1
Objective: To study the effect of dual tasking and deep brain stimulation frequency parameters on gait in advanced Parkinson's disease Materials and Methods: This is an open label interventional study evaluating 40 post STN-DBS patients with gait disturbances. All patients were diagnosed as PD by a movement disorder specialist using the United Kingdom Parkinson's Disease Society Brain Bank (UKPDSBB) criteria. Patients underwent bilateral subthalamic deep brain stimulation by a qualified neurosurgeon. Patients were managed on a combination of dopamine replacement therapy as well as deep brain stimulation. Patients were assessed by stand walk sit (SWS) test for a 5 meter distance and FOG scoring during medication 'ON' state and device “ON” state, at four frequencies 180, 130, 90, 60 HZ and device “OFF” state. Results: Out of 40 patients, 38 patients showed a significant improvement in gait at a single frequency (best response frequency) which is different for each patient. The mean FOG score showed significant improvement at all stimulation frequencies when compared to OFF stimulation (P < 0.05). The mean number of steps was 18.9 at best response frequency and 21.48 at 130 Hz (P < 0.0001). Number of freezing episodes also were significantly less with best frequency when compared to 130 Hz stimulation (0.28 and 0.65 respectively, (P < 0.0001). The mean FOG score was 6.45 at best frequency and 9.48 at 130 Hz (P < 0.0001). Mean Dual tasking score was 3.53 at best frequency and 5.15 at 130 Hz (P < 0.0002). Conclusion: Optimization of frequency setting for each patient can improve gait and that each patient may have a different optimal frequency.
中文翻译：
双任务和深部脑刺激频率参数对晚期帕金森病步态的影响。
目的：研究双重任务和脑深部刺激频率参数对晚期帕金森病步态的影响材料和方法：这是一项开放标签介入研究，评估了 40 名 STN-DBS 后步态障碍患者。所有患者均由运动障碍专家使用英国帕金森病协会脑库 (UKPDSBB) 标准诊断为 PD。由合格的神经外科医生对患者进行双侧丘脑底深部脑刺激。患者接受多巴胺替代疗法和深部脑刺激相结合的治疗。在药物“开”状态和设备“开”状态期间，在四个频率 180、130、90、60 HZ 和设备“关”状态下，通过站立步行坐 (SWS) 测试评估患者的 5 米距离和 FOG 评分。结果：在 40 名患者中，38 名患者在单个频率（最佳反应频率）下显示步态显着改善，每个患者的频率不同。与 OFF 刺激相比，平均 FOG 评分在所有刺激频率下均有显着改善（P < 0.05）。平均步数在最佳响应频率下为 18.9，在 130 Hz 下为 21.48（P < 0.0001）。与 130 Hz 刺激相比，最佳频率的冷冻发作次数也显着减少（分别为 0.28 和 0.65，（P < 0.0001）。平均 FOG 得分在最佳频率为 6.45，在 130 Hz 为 9.48（P < 0.0001）。双任务得分在最佳频率时为 3.53，在 130 Hz 时为 5.15（P < 0.0002）。结论：为每位患者优化频率设置可以改善步态，并且每位患者可能有不同的最佳频率。
更新日期：2020-05-01
Annals of Indian Academy of Neurology ( IF 1.7 ) Pub Date : 2020-05-01 , DOI: 10.4103/aian.aian_11_19 Swetha Tandra 1 , Rukmini M Kandadai 1 , Ravi P Peddisetty 2 , K J Babu 1 , T Surya Prabha 1 , S A Jabeen 1 , A K Meena 1 , Rupam Borgohain 1
Affiliation
Objective: To study the effect of dual tasking and deep brain stimulation frequency parameters on gait in advanced Parkinson's disease Materials and Methods: This is an open label interventional study evaluating 40 post STN-DBS patients with gait disturbances. All patients were diagnosed as PD by a movement disorder specialist using the United Kingdom Parkinson's Disease Society Brain Bank (UKPDSBB) criteria. Patients underwent bilateral subthalamic deep brain stimulation by a qualified neurosurgeon. Patients were managed on a combination of dopamine replacement therapy as well as deep brain stimulation. Patients were assessed by stand walk sit (SWS) test for a 5 meter distance and FOG scoring during medication 'ON' state and device “ON” state, at four frequencies 180, 130, 90, 60 HZ and device “OFF” state. Results: Out of 40 patients, 38 patients showed a significant improvement in gait at a single frequency (best response frequency) which is different for each patient. The mean FOG score showed significant improvement at all stimulation frequencies when compared to OFF stimulation (P < 0.05). The mean number of steps was 18.9 at best response frequency and 21.48 at 130 Hz (P < 0.0001). Number of freezing episodes also were significantly less with best frequency when compared to 130 Hz stimulation (0.28 and 0.65 respectively, (P < 0.0001). The mean FOG score was 6.45 at best frequency and 9.48 at 130 Hz (P < 0.0001). Mean Dual tasking score was 3.53 at best frequency and 5.15 at 130 Hz (P < 0.0002). Conclusion: Optimization of frequency setting for each patient can improve gait and that each patient may have a different optimal frequency.
中文翻译：
双任务和深部脑刺激频率参数对晚期帕金森病步态的影响。
目的：研究双重任务和脑深部刺激频率参数对晚期帕金森病步态的影响材料和方法：这是一项开放标签介入研究，评估了 40 名 STN-DBS 后步态障碍患者。所有患者均由运动障碍专家使用英国帕金森病协会脑库 (UKPDSBB) 标准诊断为 PD。由合格的神经外科医生对患者进行双侧丘脑底深部脑刺激。患者接受多巴胺替代疗法和深部脑刺激相结合的治疗。在药物“开”状态和设备“开”状态期间，在四个频率 180、130、90、60 HZ 和设备“关”状态下，通过站立步行坐 (SWS) 测试评估患者的 5 米距离和 FOG 评分。结果：在 40 名患者中，38 名患者在单个频率（最佳反应频率）下显示步态显着改善，每个患者的频率不同。与 OFF 刺激相比，平均 FOG 评分在所有刺激频率下均有显着改善（P < 0.05）。平均步数在最佳响应频率下为 18.9，在 130 Hz 下为 21.48（P < 0.0001）。与 130 Hz 刺激相比，最佳频率的冷冻发作次数也显着减少（分别为 0.28 和 0.65，（P < 0.0001）。平均 FOG 得分在最佳频率为 6.45，在 130 Hz 为 9.48（P < 0.0001）。双任务得分在最佳频率时为 3.53，在 130 Hz 时为 5.15（P < 0.0002）。结论：为每位患者优化频率设置可以改善步态，并且每位患者可能有不同的最佳频率。
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