Some people with Parkinson’s disease (PD) report poorer dynamic postural stability following high-frequency deep brain stimulation of the subthalamic nucleus (STN-DBS), which may contribute to an increased falls risk. However, some studies have shown low-frequency (60 Hz) STN-DBS improves clinical measures of postural stability, potentially providing support for this treatment. This double-blind randomised crossover study aimed to investigate the effects of low-frequency STN-DBS compared to high-frequency stimulation on objective measures of gait rhythmicity in people with PD. During high- and low-frequency STN-DBS and while off-medication, participants completed assessments of symptom severity and walking (e.g., Timed Up-and-Go). During comfortable walking, the harmonic ratio, an objective measures of gait rhythmicity, was derived from head- and trunk-mounted accelerometers to provide insight in dynamic postural stability. Lower harmonic ratios represent less rhythmic walking and have discriminated people with PD who experience falls. Linear mixed model analyses were performed on fourteen participants. Low-frequency STN-DBS significantly improved medial–lateral and vertical trunk rhythmicity compared to high-frequency. Improvements were independent of electrode location and total electrical energy delivered. No differences were noted between stimulation conditions for temporal gait measures, clinical mobility measures, motor symptom severity or the presence of gait retropulsion. This study provides evidence for the acute benefits of low-frequency stimulation for gait outcomes in STN-DBS PD patients, independent of electrode location. However, the perceived benefits of this therapy may be diminished for people who experienced significant tremor pre-operatively, as lower frequencies may cause these symptoms to re-emerge. Trial registration: This study was prospectively registered with the Australian and New Zealand Clinical Trials Registry on 5 June 2018 (ACTRN12618000944235).

中文翻译：

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低频 STN-DBS 为帕金森病提供急性步态改善：一项双盲随机交叉可行性试验

一些帕金森病 (PD) 患者报告说，在对丘脑底核 (STN-DBS) 进行高频深部脑刺激后，动态姿势稳定性较差，这可能会导致跌倒风险增加。然而，一些研究表明低频 (60 Hz) STN-DBS 改善了姿势稳定性的临床测量，可能为这种治疗提供支持。这项双盲随机交叉研究旨在调查低频 STN-DBS 与高频刺激相比对 PD 患者步态节律的客观测量的影响。在高频和低频 STN-DBS 期间以及停药期间，参与者完成了对症状严重程度和步行的评估（例如，Timed Up-and-Go）。在舒适的步行过程中，谐波比是步态节奏的客观衡量标准，源自安装在头部和躯干上的加速度计，以提供动态姿势稳定性的洞察力。较低的谐波比率代表较少有节奏的步行，并区分了经历过跌倒的 PD 患者。对 14 名参与者进行了线性混合模型分析。与高频相比，低频 STN-DBS 显着改善了躯干的内外侧和垂直节律。改进与电极位置和传递的总电能无关。在时间步态测量、临床活动性测量、运动症状严重程度或步态后退的存在的刺激条件之间没有注意到差异。这项研究为低频刺激对 STN-DBS PD 患者步态结果的急性益处提供了证据，与电极位置无关。然而，对于术前经历过明显震颤的人来说，这种疗法的预期好处可能会减弱，因为频率较低可能会导致这些症状再次出现。试验注册：本研究于 2018 年 6 月 5 日在澳大利亚和新西兰临床试验注册处前瞻性注册（ACTRN12618000944235）。