ArticleNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2025
Sixty hertz STN-DBS and L-Dopa reduces gait variability in parkinson's disease.
Article in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveWe investigated the effects of Subthalamic Deep Brain Stimulation (STN-DBS) at high (180hz) and low frequency (60hz) and L-dopa on variability of spatiotemporal gait measures in an advanced PD cohort. MATERIALS AND
methodsThis study consisted of PD subjects with chronic bilateral STN-DBS. Each combination of medication state (OFF/ON) and stimulation frequency (60 Hz/180Hz) were assessed and randomized across electrode contacts. Instrumented stand and walk tests were performed for each stimulation-medication condition and coefficient of variance (CV) was computed for each lower limb gait parameter. LM-ANOVA was employed for analysis.
resultsTwenty-two PD subjects with chronic DBS were recruited with an average age of 63.9(SD 9) years. L-dopa reduced variability in both spatial and temporal gait parameters: cadence (L/R, p < 0.0001), gait speed (L/R, p < 0.0001), toe off angle (L/R, p < 0.0001), SLS (L, p = 0.0002; R, p = 0.001), stance (L, p = 0.01, R, p < 0.0001;), step duration (L, p < 0.0001; R, p = 0.004), stride length (L/R, p < 0.0001), and foot swing (L, p = 0.0003; R, p < 0.0001). Low and high frequency DBS reduced variability in cadence, foot elevation midswing, speed, right foot strike angle, SLS, stand, step duration, stride length, and foot swing. 60 Hz STN-DBS synergistically reduced left foot mid-swing elevation variability (p = 0.02) when combined with medication.
conclusionThis study demonstrates significant reduction in variability of spatial and temporal gait measures from L-dopa and STN-DBS. It further reveals a synergistic effect of 60Hz STN-DBS with L-dopa in reducing foot elevation midswing variability.
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