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The investigators aims to assess the effectiveness of behavioral interventions based on sensory cues on freezing of gait in patients with Parkinson's disease after bilateral subthalamic nucleus deep brain stimulation.
Freezing of gait (FOG) leads to falling and is one of the major determinants of quality of life and prognosis in Parkinson's disease (PD). Previous evidence suggests that subthalamic nucleus deep brain stimulation (STN-DBS) improve off-medication FOG but not on-medication FOG in patients with PD. Furthermore, off-mediation FOG persist or even worsen after STN-DBS in some PD patients.
Although visual and auditory cues are known to improve FOG in research setting, it is unclear whether these cues are effective for FOG in real clinical setting. Most previous studies have used wearable devices to use sensory cues, but such devices are difficult to apply in clinical practice.
Therefore, this study aims to investigate the effectiveness of behavioral interventions based on visual and auditory cues in patients with PD after bilateral STN-DBS. Participants undergo clinical evaluations including the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Frontal Assessment Battery (FAB), Unified Parkinson 's Disease Rating Scale (UPDRS), Freezing of Gait-Questionnaire (FOG-Q), and the average number of falling over the last week. Then, participants receive behavior intervention training that includes how to apply visual and auditory cues to freezing of gait in real clinical practice. To investigate the education effect, FOG-Q and the average number of falling over the last week are repetitively assessed at 2-week and 4-week follow-ups using a phone call.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| PD with FOG | Experimental | Patients with Parkinson's disease who complain of freezing of gait |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| behavioral intervention based on sensory cues | Behavioral | Patients will receive behavior intervention training that includes how to apply visual and auditory cues to freezing of gait in real clinical practice. |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline to 4-week f/u in FOG-Q subscore (Q4+Q5+Q6) | The FOG-Q will be used to determine the efficacy of behavior intervention based on sensory cues. | baseline, after 4 weeks |
| Change from baseline to 4-week f/u in the number of falling | We will ask about the average number of falling over the last week at baseline and at 4-week f/u. | baseline, after 4 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline to 4-week f/u in FOG-Q total score | The FOG-Q will be used to determine the efficacy of behavior intervention based on sensory cues. | baseline, after 4 weeks |
| Change from baseline to 2-week f/u in FOG-Q |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Beomseok Jeon, Professor | Contact | +82-2-2072-2876 | brain@snu.ac.kr |
| Name | Affiliation | Role |
|---|---|---|
| Beomseok Jeon, Professor | Seoul National University Hospital | Principal Investigator |
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| ID | Term |
|---|---|
| D010300 | Parkinson Disease |
| ID | Term |
|---|---|
| D020734 | Parkinsonian Disorders |
| D001480 | Basal Ganglia Diseases |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
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The FOG-Q will be used to determine the efficacy of behavior intervention based on sensory cues.
| baseline, after 2 weeks |
| Change from baseline to 2-week f/u in the number of falling | We will ask about the average number of falling over the last week at baseline and at 2-week f/u. | baseline, after 2 weeks |
| Change from baseline to 2-week f/u in FOG-Q subscore (Q4+Q5+Q6) | The FOG-Q will be used to determine the efficacy of behavior intervention based on sensory cues. | baseline, after 2 weeks |
| D009422 | Nervous System Diseases |
| D009069 | Movement Disorders |
| D000080874 | Synucleinopathies |
| D019636 | Neurodegenerative Diseases |