Selective use of low frequency stimulation in Parkinson's disease based on absence of tremor.

BACKGROUND: High frequency stimulation (HFS) of the subthalamic nucleus is one of the most effective treatments for advanced Parkinson's disease (PD). HFS has provided beneficial improvements in the cardinal features of PD, but has not been proven as effective for addressing the axial predominant le...

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Publicado en:NeuroRehabilitation Vol. 33; no. 2; pp. 305 - 313
Autores principales: Stegemöller, Elizabeth L., Vallabhajosula, Srikant, Haq, Ihtsham, Hwynn, Nelson, Hass, Chris J., Okun, Michael S.
Formato: research tables/charts Journal Article
Publicado: Sage Publications Inc. 2013
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Selective use of low frequency stimulation in Parkinson's disease based on absence of tremor.
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          Stegemöller, Elizabeth L.
          Vallabhajosula, Srikant
          Haq, Ihtsham
          Hwynn, Nelson
          Hass, Chris J.
          Okun, Michael S.
        affil: Department of Applied Physiology and Kinesiology and Center for Movement Disorders & Neurorestoration, University of Florida, Gainesville, FL, USA
      sug:
        subj:
          Electric Stimulation Methods
          Parkinson Disease Therapy
          Scales
          Human
          Parkinson Disease Psychosocial Factors
          Parkinson Disease Physiopathology
          Gait Physiology
          Gait Disorders, Neurologic Therapy
          Balance, Postural
          Middle Age
          Aged
          Adult
          Analysis of Variance
          Data Analysis Software
          Post Hoc Analysis
          Descriptive Statistics
          Middle Aged: 45-64 years
          Aged: 65+ years
          Adult: 19-44 years
      ab: BACKGROUND: High frequency stimulation (HFS) of the subthalamic nucleus is one of the most effective treatments for advanced Parkinson's disease (PD). HFS has provided beneficial improvements in the cardinal features of PD, but has not been proven as effective for addressing the axial predominant levodopa resistant symptoms, such as speech disturbances, gait disturbances, and postural instability. Recent studies have suggested that changes in stimulation parameters may influence differing PD symptoms. OBJECTIVE: The purpose of this study was to compare the effects of low frequency stimulation (LFS) versus HFS on the Unified Parkinson's Disease Rating Scale (UPDRS), gait, balance, and verbal fluency. METHODS: Eight tremor dominant and nine non-tremor dominant participants with bilateral deep brain stimulation of the subthalamic nucleus were tested off stimulation, during LFS, and during HFS. RESULTS: Results revealed that HFS significantly reduced UPDRS tremor score in the tremor dominant group; however no differences emerged within the non-tremor dominant group. No differences between groups or stimulation conditions were found for gait, balance, and verbal fluency measures. CONCLUSION: These results may suggest that HFS is better than LFS for reducing tremor in tremor dominant patients. However, patients with mild or no tremor show no acute differences in benefit from LFS as compared to HFS.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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