Low-frequency subthalamic nucleus stimulation in Parkinson's disease: a randomized clinical trial.
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.
Department of Neurosurgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Hui Ming
HM
Khoo
Haruhiko
H
Kishima
Koichi
K
Hosomi
Tomoyuki
T
Maruo
Naoki
N
Tani
Satoru
S
Oshino
Toshio
T
Shimokawa
Masaru
M
Yokoe
Hideki
H
Mochizuki
Youichi
Y
Saitoh
Toshiki
T
Yoshimine
D001703:Biophysics; D018592:Cross-Over Studies; D046690:Deep Brain Stimulation / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D010300:Parkinson Disease / Q000628:therapy*; D018709:Statistics, Nonparametric; D020531:Subthalamic Nucleus / Q000502:physiology*
Parkinson's disease; deep brain stimulation; low-frequency stimulation; motor function; subthalamic nucleus