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Low-frequency Subthalamic Nucleus Stimulation In Parkinson's Disease: A Randomized Clinical Trial.

Hui Ming Khoo, Haruhiko Kishima, Koichi Hosomi, Tomoyuki Maruo, Naoki Tani, Satoru Oshino, Toshio Shimokawa, Masaru Yokoe, Hideki Mochizuki, Youichi Saitoh, Toshiki Yoshimine
Published 2014 · Psychology, Medicine
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BACKGROUND Low-frequency, bilateral stimulation of the subthalamic nucleus can improve axial symptoms of advanced Parkinson's disease (PD), but it is not particularly effective for segmental symptoms. METHODS The optimal contacts for low-frequency (60 Hz) and high-frequency (130 Hz) single monopolar stimulation were determined. Then, in a randomized, double-blind, prospective crossover manner, 60-Hz and 130-Hz stimulations via the respective optimal contacts were compared for immediate efficacy in improving the motor function of patients with PD. RESULTS The optimal contacts for 60-Hz stimulation were situated more ventrally than those for 130-Hz stimulation (P = 0.038). Under the respective optimal, single monopolar stimulation, 60 Hz provided superior efficacy over 130 Hz in improving the total Unified Parkinson's Disease Rating Scale motor score (P < 0.001) and the akinesia (P = 0.011) and axial motor signs (P = 0.012) subscores without compromising the therapeutic effect on tremor and rigidity. CONCLUSIONS Low-frequency stimulation via the optimal contacts is effective in improving overall motor function of patients with PD.
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