Background: Freezing of gait (FOG) is a common symptom in Parkinson’s disease (PD) and can be difficult to treat with dopaminergic medications or with deep brain stimulation (DBS). Novel stimulation paradigms have been proposed to address suboptimal responses to conventional DBS programming methods. Burst-cycling deep brain stimulation (BCDBS) delivers current in various frequencies of bursts (e.g. 4-Hz, 10-Hz or 15-Hz), while maintaining an intra-burst frequency identical to conventional DBS. Objective: To evaluate the safety and tolerability of BCDBS in PD patients with FOG. Methods: Ten PD subjects with STN or GPi DBS and complaints of FOG were recruited for this single center, single blinded within-subject crossover study. For each subject, we compared 4-Hz, 10-Hz and 15-Hz BCDBS to conventional DBS during the PD medication-OFF state. Results: There were no serious adverse events with BCDBS. It was feasible and straightforward to program BCDBS in the clinic setting. The benefit was comparable to conventional DBS in measures of FOG, functional mobility and in PD motor symptoms. BCDBS had lower battery consumption when compared to conventional DBS. Conclusions: BCDBS was feasible, safe and well tolerated and it has potential to be a viable future DBS programming strategy.

中文翻译：

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突发性深部脑刺激在帕金森氏病中步态冻结的安全性和耐受性

背景：步态冻结（FOG）是帕金森氏病（PD）的常见症状，使用多巴胺能药物或深部脑刺激（DBS）可能难以治疗。已经提出了新颖的刺激范例来解决对常规DBS编程方法的次优响应。突发周期深部脑刺激（BCDBS）以各种突发频率（例如4 Hz，10 Hz或15 Hz）提供电流，同时保持与常规DBS相同的突发频率。目的：评价BCDBS在PD合并FOG患者中的安全性和耐受性。方法：该单中心，单盲，受试者内部交叉研究招募了10名STN或GPi DBS以及PD投诉的PD受试者。对于每个受试者，我们在PD药物关闭状态下将4-Hz，10-Hz和15-Hz BCDBS与常规DBS进行了比较。结果：BCDBS没有严重的不良事件。在临床环境中对BCDBS进行编程是可行且直接的。在测量FOG，功能活动性和PD运动症状方面，该优势可与传统DBS媲美。与传统的DBS相比，BCDBS的电池消耗更低。结论：BCDBS是可行，安全且耐受性良好的，并且有可能成为未来可行的DBS编程策略。