Congratulations to Drs. Michael Okun, Kelly Foote and Aysegul Gunduz on the publication of “A RESPONSIVE DBS APPROACH TO TREAT FREEZING OF GAIT,” which appears in the January/February issue of Brain Stimulation.
Abstract
Treating medication-refractory freezing of gait (FoG) in Parkinson’s disease (PD) remains challenging despite several trials reporting improvements in motor symptoms using subthalamic nucleus or globus pallidus internus (GPi) deep brain stimulation (DBS). Pedunculopontine nucleus (PPN) region DBS has been used for medication-refractory FoG, with mixed findings. FoG, as a paroxysmal phenomenon, provides an ideal framework for the possibility of responsive DBS (R-DBS). We demonstrated the feasibility of R-DBS in five subjects with both “on” and “off” medication freezing based on a 1–8 Hz modulation in the PPN region, which correlated with human gait. This PPN feature correlated with walking speed. PPN low-frequency synchronization and GPi beta desynchronization were observed as subjects progressed from rest to ambulatory tasks. The primary clinical outcome in three of the five subjects was achieved at 6 months.