Deep Brain Stimulation Beneficial for Treating Freezing of Gait in Patients With Parkinson Disease

Deep brain stimulation (DBS) is a promising treatment for severe freezing of gait in patients with Parkinson disease, according to results from a systematic review published in the British Journal of Neurosurgery.

“Dopaminergic drugs are common treatments for Parkinson disease and freezing of gait; however, these drugs may worsen freezing of gait,” wrote researchers. “DBS is another option used to treat selected patients.”

The systematic review included 13 studies investigating DBS for freezing of gait. In the studies, DBS targeted the subthalamic nucleus, substantia nigra, or pedunculopontine nucleus.

According to study authors, low-frequency stimulation was superior to high-frequency stimulation for improving freezing of gait. However, the efficacy of both low-frequency and high-frequency stimulation decreased over the long term.

The effect of amplitude varied and needed to be adjusted for individual patients, the review found. Meanwhile, bilateral stimulation was more effective than unilateral stimulation.

“Bilateral, low-frequency stimulation combined with medical therapy is associated with better responses, especially in the first 2 years of treatment,” concluded researchers. “However, individualizing the DBS parameters should be considered to optimize treatment response.”

Reference:
Razmkon A, Abdollahifard S, Taherifard E, Roshanshad A, Shahrivar K. Effect of deep brain stimulation on freezing of gait in patients with Parkinson’s disease: a systematic review. Br J Neurosurg. Published online May 23, 2022; 1-9. doi:10.1080/02688697.2022.2077308