Differential Spatiotemporal Gait Effects with Frequency and Dopaminergic Modulation in STN-DBS

Overview

Journal Front Aging Neurosci

Specialty Geriatrics

Date 2023 Oct 16

PMID 37842127

Authors

Ritesh A Ramdhani

Jeremy Watts

Myriam Kline

Toni Fitzpatrick

Martin Niethammer

Anahita Khojandi

Affiliations

Soon will be listed here.

Abstract

Objective: The spatiotemporal gait changes in advanced Parkinson's disease (PD) remain a treatment challenge and have variable responses to L-dopa and subthalamic deep brain stimulation (STN-DBS). The purpose of this study was to determine whether low-frequency STN-DBS (LFS; 60 Hz) elicits a differential response to high-frequency STN-DBS (HFS; 180 Hz) in spatiotemporal gait kinematics.

Methods: Advanced PD subjects with chronic STN-DBS were evaluated in both the OFF and ON medication states with LFS and HFS stimulation. Randomization of electrode contact pairs and frequency conditions was conducted. Instrumented Stand and Walk assessments were carried out for every stimulation/medication condition. LM-ANOVA was employed for analysis.

Results: Twenty-two PD subjects participated in the study, with a mean age (SD) of 63.9 years. Significant interactions between frequency (both LFS and HFS) and electrode contact pairs (particularly ventrally located contacts) were observed for both spatial (foot elevation, toe-off angle, stride length) and temporal (foot speed, stance, single limb support (SLS) and foot swing) gait parameters. A synergistic effect was also demonstrated with L-dopa and both HFS and LFS for right SLS, left stance, left foot swing, right toe-off angle, and left arm range of motion. HFS produced significant improvement in trunk and lumbar range of motion compared to LFS.

Conclusion: The study provides evidence of synergism of L-dopa and STN-DBS on lower limb spatial and temporal measures in advanced PD. HFS and LFS STN-DBS produced equivalent effects among all other tested lower limb gait features. HFS produced significant trunk and lumbar kinematic improvements.

Citing Articles

Sixty hertz STN-DBS and L-Dopa reduces gait variability in parkinson's disease.

Ramdhani R, Kline M, Islam S, Fitzpatrick T, Khojandi A Neurol Sci. 2025; .

PMID: 39976880 DOI: 10.1007/s10072-025-08053-6.

Machine learning model comparison for freezing of gait prediction in advanced Parkinson's disease.

Watts J, Niethammer M, Khojandi A, Ramdhani R Front Aging Neurosci. 2024; 16:1431280.

PMID: 39006221 PMC: 11240851. DOI: 10.3389/fnagi.2024.1431280.

Differential Responses to Low- and High-Frequency Subthalamic Nucleus Deep Brain Stimulation on Sensor-Measured Components of Bradykinesia in Parkinson's Disease.

Mishra A, Bajaj V, Fitzpatrick T, Watts J, Khojandi A, Ramdhani R Sensors (Basel). 2024; 24(13).

PMID: 39001075 PMC: 11244034. DOI: 10.3390/s24134296.

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