Department of Neurology, University of Chicago Medical Center, 5841 South Maryland Avenue, MC 2030, Chicago, IL 60637, USA.
J Neurol Neurosurg Psychiatry. 2012 Oct;83(10):1015-7. doi: 10.1136/jnnp-2011-302091. Epub 2012 Jun 13.
Patients with Parkinson's disease (PD) may develop freezing of gait (FOG) with chronic deep brain stimulation (DBS) of the subthalamic nucleus (STN) at the commonly used frequency of 130 Hz and FOG can be ameliorated by 60 Hz stimulation in some patients. It is not clear whether the development of FOG is due to the disease progression or the chronic stimulation at this 130 Hz frequency.
To investigate the effect of stimulation frequency on immediate FOG in newly activated STN DBS patient with PD and determine if stimulation frequency alone could affect the FOG.
Two cases of PD who developed FOG immediately upon activation of the newly placed STN DBS were studied for the effect of stimulation frequency on FOG in both off' and on' medication status.
Both patients developed severe FOG with the commonly used 130 Hz stimulation. Switching the frequency to 60 Hz immediately alleviated the FOG, without change in contacts, voltages and pulse widths. This frequency effect on FOG was present in both off' and on' statuses and remained effective during the 10-month follow-up period.
These two cases demonstrate that lower frequency stimulation of 60 Hz could improve FOG, while the commonly used 130 Hz stimulation could cause FOG or make it worse. In addition, the beneficial effect of low frequency DBS was additive to dopaminergic medication effect and included other axial symptoms.
患有帕金森病（PD）的患者可能会在使用 130Hz 常用频率对丘脑底核（STN）进行慢性深部脑刺激（DBS）时出现步态冻结（FOG），而在某些患者中，60Hz 刺激可改善 FOG。目前尚不清楚 FOG 的发展是由于疾病进展还是由于该 130Hz 频率的慢性刺激。
研究刺激频率对新激活的 STN-DBS 治疗 PD 患者即时 FOG 的影响，并确定刺激频率是否会单独影响 FOG。
研究了 2 例新放置的 STN-DBS 后立即出现 FOG 的 PD 患者，以研究刺激频率对“关”药和“开”药状态下 FOG 的影响。
两位患者在使用常用的 130Hz 刺激时均出现严重的 FOG。将频率切换至 60Hz 后可立即缓解 FOG，而无需改变触点、电压和脉冲宽度。这种频率对 FOG 的影响在“关”药和“开”药状态下均存在，在 10 个月的随访期间仍然有效。
这两个案例表明，60Hz 的低频刺激可改善 FOG，而常用的 130Hz 刺激可能会导致 FOG 或使其恶化。此外，低频 DBS 的有益效果可与多巴胺能药物的效果相加，并包括其他轴性症状。
