Could adaptive deep brain stimulation treat freezing of gait in Parkinson’s disease?

Journal of Neurology, Journal Year: 2025, Volume and Issue: 272(4)

Published: March 12, 2025

Abstract Next-generation neurostimulators capable of running closed-loop adaptive deep brain stimulation (aDBS) are about to enter the clinical landscape for treatment Parkinson’s disease. Already promising results using aDBS have been achieved symptoms such as bradykinesia, rigidity and motor fluctuations. However, heterogeneity freezing gait (FoG) with its wide range presentations exacerbation cognitive emotional load make it more difficult predict treat. Currently, a successful strategy ameliorate FoG lacks robust oscillatory biomarker. Furthermore, technical implementation suppressing an upcoming episode in real-time represents significant challenge. This review describes neurophysiological signals underpinning explains how is currently being implemented. we offer discussion addressing both theoretical practical areas that will need be resolved if going able unlock full potential treat FoG.

Language: Английский

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The role of deep brain stimulation in Parkinson’s disease: an overview and update on new developments

Neuropsychiatric Disease and Treatment, Journal Year: 2017, Volume and Issue: Volume 13, P. 723 - 732

Published: March 1, 2017

Abstract: Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by the loss of neuronal dopamine production in brain. Oral therapies primarily augment dopaminergic pathway. As progresses, more continuous delivery therapy commonly needed. Deep brain stimulation (DBS) has become an effective option for several different neurologic and psychiatric conditions, including PD. It currently US Food Drug Administration approval PD essential tremor, as well humanitarian device exception dystonia obsessive-compulsive disorder. For treatment, it approved specifically those patients suffering from complications pharmacotherapy, motor fluctuations or dyskinesias, process at least 4 years duration. Studies have demonstrated superiority DBS medical management compared to alone selected patients. Optimal patient selection criteria, choice target, programming methods other indications are important topics that continue be explored remain works progress. In addition, new hardware options, such types leads, software options recently available, increasing potential greater efficacy and/or reduced side effects. This review gives overview therapeutic PD, highlighting some recent changes with surgical therapy. Keywords: disease, deep stimulation, functional neurosurgery

Language: Английский

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How tandem gait stumbled into the neurological exam: a review

Neurological Sciences, Journal Year: 2017, Volume and Issue: 39(1), P. 23 - 29

Published: Sept. 11, 2017

Language: Английский

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Freezing of Gait can persist after an acute levodopa challenge in Parkinson’s disease

npj Parkinson s Disease, Journal Year: 2019, Volume and Issue: 5(1)

Published: Nov. 22, 2019

Study objectives included testing whether presumed levodopa-unresponsive freezing of gait (FOG) in Parkinson's disease (PD) actually persists the presence adequate dopaminergic dosing and to investigate other parkinsonian features their responsiveness therapy varies across patients without FOG (NO-FOG), with levodopa-responsive (OFF-FOG), (ONOFF-FOG). Fifty-five PD completed levodopa challenges after >12-h OFF supratherapeutic doses medications. Observed responses FOG, measured MDS-UPDRS-III during patient reported full "ON", were used classify them as NO-FOG, OFF-FOG, or ONOFF-FOG. Serum levels measured. Only those ≥20% improvement score analyses. Levodopa challenge was sufficient bring about a "ON" state 45 patients. Levodopa-equivalent-dose utilized 142 ± 56% patients' typical morning doses. Overall, 19/45 exhibited (ONOFF-FOG), 11 classified 15 NO-FOG. Linear mixed models revealed highly significant association between serum level total that similar groups. The ONOFF-FOG group significantly higher New-FOG-questionnaire MDS-UPDRS-II scores compared OFF-FOG group. Among subdomains effects (highest ONOFF-FOG) identified for axial features. We found can persist brought by ample PD. Other measures also be among only. These data provide evidence is distinct from responsive freezing.

Language: Английский

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Focus on the pedunculopontine nucleus. Consensus review from the May 2018 brainstem society meeting in Washington, DC, USA

Clinical Neurophysiology, Journal Year: 2019, Volume and Issue: 130(6), P. 925 - 940

Published: March 28, 2019

Language: Английский

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