Sobell Department of Motor Neuroscience, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK.
Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
J Parkinsons Dis. 2018;8(2):267-271. doi: 10.3233/JPD-171150.
Whilst changes in the frequency of subthalamic deep brain stimulation (STN-DBS) have been proposed to improve control of tremor or axial motor features in Parkinson's disease (PD), little is known about the effects of frequency changes on upper limb motor function, particularly bradykinesia.
To investigate the acute effects of various STN-DBS frequencies (40-160 Hz, 40 Hz intervals) on upper limb motor function.
We carried out a randomised, double-blind study on 20 PD patients with chronic STN-DBS using the Simple and Assembly components of the Purdue Pegboard (PP) test and a modified upper limb version of the UPDRS-III (UL-UPDRS-III).
There was no significant effect of frequency on bradykinesia on the Simple PP task or the UL-UPDRS-III. There was an effect of frequency on the Assembly PP score when comparing all frequencies (p = 0.019) and between 80 Hz and 130 Hz (p = 0.007), with lower frequencies yielding a better performance. Rigidity and Tremor scores were significantly reduced with higher (>80 Hz) compared to lower (40 Hz) frequencies.
Our findings suggest that a wide range of frequencies are efficacious in improving acute upper-limb motor function. Reducing the frequency of stimulation down to 80 Hz is safe and has a similar clinical effect to higher frequencies. Therefore, a wider range of frequencies are available when it comes adjusting patients' acute settings without the risk of worsening bradykinesia.
虽然已经提出改变丘脑底核深部脑刺激（STN-DBS）的频率可以改善帕金森病（PD）的震颤或轴向运动特征的控制，但对于频率变化对上肢运动功能的影响，尤其是运动迟缓，知之甚少。
研究不同 STN-DBS 频率（40-160 Hz，40 Hz 间隔）对上肢运动功能的急性影响。
我们对 20 例慢性 STN-DBS 的 PD 患者进行了一项随机、双盲研究，使用 Purdue 钉板（PP）测试的简单和组装部分以及改良的 UPDRS-III 上肢部分（UL-UPDRS-III）进行评估。
频率对简单 PP 任务或 UL-UPDRS-III 中的运动迟缓没有显著影响。当比较所有频率（p=0.019）和 80 Hz 与 130 Hz 之间的频率（p=0.007）时，频率对组装 PP 评分有影响，低频时表现更好。与低频（40 Hz）相比，较高频率（>80 Hz）时，僵硬和震颤评分显著降低。
我们的发现表明，广泛的频率都能有效改善急性上肢运动功能。将刺激频率降低到 80 Hz 是安全的，并且与较高频率具有相似的临床效果。因此，在调整患者的急性设置时，可以使用更广泛的频率范围，而不会增加运动迟缓的风险。
