Cycling Deep Brain Stimulation on Parkinson's Disease Gait

Effects of Cycling Deep Brain Stimulation on Parkinson's Disease Gait

Our hypothesis is that cycling DBS stimulation would be superior or non-inferior to regular DBS stimulation in Parkinson's disease patients with gait impairment. The objective of this study is compare gait disorders in patients with Parkinson's disease and DBS in 4 different scenarios: 1) regular continuous high frequency (>130Hz) stimulation, 2) cycling high frequency (>130Hz) stimulation (40sec on, 2sec off), 3) low-frequency (80Hz) continuous stimulation and 4) cycling low frequency (80Hz) stimulation (40sec on, 2sec off)

Gait disorders such as falls, freezing of gait, reduction of speed, shuffling, and multi-stepped turning are common in patients with moderate and advanced Parkinson's disease. Compared to appendicular symptoms (bradykinesia, tremor, and rigidity), gait disorders tend to be more resistant to medical and regular deep brain stimulation treatment, and greatly impairs patients' quality of life and daily living activities. Some stimulation strategies have been tried to improve gait in Parkinson's disease patients, but so far most of them resulted in concomitant worsening of appendicular symptoms. However, new stimulation strategies such as cycling stimulation can potentially improve gait disorders without impairment of appendicular symptoms.

Inclusion Criteria:

• Diagnosis of idiopathic Parkinson's disease
• Currently receiving Deep Brain Stimulation as a Parkinson's disease treatment
• Hoehn & Yahr stage between 2-4 during off-medication
• Underlying gait disorders despite optimal medical and stimulation treatment: score over or equal to 1 in the subitem 2.12 of the MDS-UPDRS scale
• Willingness to comply with all study procedures

Exclusion Criteria:

• Active moderate/severe psychiatric condition
• Active infection or other uncontrolled moderate/grave comorbidities
• Treatment with experimental drug
• Pregnancy or breast-feeding