Effect of subthalamic coordinated reset deep brain stimulation on Parkinsonian gait

IntroductionCoordinated Reset Deep Brain Stimulation (CR DBS) is a novel DBS approach for treating Parkinson's disease (PD) that uses lower levels of burst stimulation through multiple contacts of the DBS lead. Though CR DBS has been demonstrated to have sustained therapeutic effects on rigidit...

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Main Authors: Kai M. Bosley, Ziling Luo, Sana Amoozegar, Kit Acedillo, Kanon Nakajima, Luke A. Johnson, Jerrold L. Vitek, Jing Wang
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-08-01
Series:Frontiers in Neuroinformatics
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fninf.2023.1185723/full
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author Kai M. Bosley
Ziling Luo
Sana Amoozegar
Kit Acedillo
Kanon Nakajima
Luke A. Johnson
Jerrold L. Vitek
Jing Wang
author_facet Kai M. Bosley
Ziling Luo
Sana Amoozegar
Kit Acedillo
Kanon Nakajima
Luke A. Johnson
Jerrold L. Vitek
Jing Wang
author_sort Kai M. Bosley
collection DOAJ
description IntroductionCoordinated Reset Deep Brain Stimulation (CR DBS) is a novel DBS approach for treating Parkinson's disease (PD) that uses lower levels of burst stimulation through multiple contacts of the DBS lead. Though CR DBS has been demonstrated to have sustained therapeutic effects on rigidity, tremor, bradykinesia, and akinesia following cessation of stimulation, i.e., carryover effect, its effect on Parkinsonian gait has not been well studied. Impaired gait is a disabling symptom of PD, often associated with a higher risk of falling and a reduced quality of life. The goal of this study was to explore the carryover effect of subthalamic CR DBS on Parkinsonian gait.MethodsThree non-human primates (NHPs) were rendered Parkinsonian and implanted with a DBS lead in the subthalamic nucleus (STN). For each animal, STN CR DBS was delivered for several hours per day across five consecutive days. A clinical rating scale modified for NHP use (mUPDRS) was administered every morning to monitor the carryover effect of CR DBS on rigidity, tremor, akinesia, and bradykinesia. Gait was assessed quantitatively before and after STN CR DBS. The stride length and swing speed were calculated and compared to the baseline, pre-stimulation condition.ResultsIn all three animals, carryover improvements in rigidity, bradykinesia, and akinesia were observed after CR DBS. Increased swing speed was observed in all the animals; however, improvement in stride length was only observed in NHP B2. In addition, STN CR DBS using two different burst frequencies was evaluated in NHP B2, and differential effects on the mUPDRS score and gait were observed.DiscussionAlthough preliminary, our results indicate that STN CR DBS can improve Parkinsonian gait together with other motor signs when stimulation parameters are properly selected. This study further supports the continued development of CR DBS as a novel therapy for PD and highlights the importance of parameter selection in its clinical application.
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spelling doaj.art-bbc30ce352994a1eb70e2f383e500b0c2023-08-24T15:17:02ZengFrontiers Media S.A.Frontiers in Neuroinformatics1662-51962023-08-011710.3389/fninf.2023.11857231185723Effect of subthalamic coordinated reset deep brain stimulation on Parkinsonian gaitKai M. Bosley0Ziling Luo1Sana Amoozegar2Kit Acedillo3Kanon Nakajima4Luke A. Johnson5Jerrold L. Vitek6Jing Wang7Department of Neurology, University of Minnesota, Minneapolis, MN, United StatesDepartment of Neurology, University of Minnesota, Minneapolis, MN, United StatesDepartment of Neurology, University of Minnesota, Minneapolis, MN, United StatesDepartment of Neurology, University of Minnesota, Minneapolis, MN, United StatesNeuroscience Program, Macalester College, Saint Paul, MN, United StatesDepartment of Neurology, University of Minnesota, Minneapolis, MN, United StatesDepartment of Neurology, University of Minnesota, Minneapolis, MN, United StatesDepartment of Neurology, University of Minnesota, Minneapolis, MN, United StatesIntroductionCoordinated Reset Deep Brain Stimulation (CR DBS) is a novel DBS approach for treating Parkinson's disease (PD) that uses lower levels of burst stimulation through multiple contacts of the DBS lead. Though CR DBS has been demonstrated to have sustained therapeutic effects on rigidity, tremor, bradykinesia, and akinesia following cessation of stimulation, i.e., carryover effect, its effect on Parkinsonian gait has not been well studied. Impaired gait is a disabling symptom of PD, often associated with a higher risk of falling and a reduced quality of life. The goal of this study was to explore the carryover effect of subthalamic CR DBS on Parkinsonian gait.MethodsThree non-human primates (NHPs) were rendered Parkinsonian and implanted with a DBS lead in the subthalamic nucleus (STN). For each animal, STN CR DBS was delivered for several hours per day across five consecutive days. A clinical rating scale modified for NHP use (mUPDRS) was administered every morning to monitor the carryover effect of CR DBS on rigidity, tremor, akinesia, and bradykinesia. Gait was assessed quantitatively before and after STN CR DBS. The stride length and swing speed were calculated and compared to the baseline, pre-stimulation condition.ResultsIn all three animals, carryover improvements in rigidity, bradykinesia, and akinesia were observed after CR DBS. Increased swing speed was observed in all the animals; however, improvement in stride length was only observed in NHP B2. In addition, STN CR DBS using two different burst frequencies was evaluated in NHP B2, and differential effects on the mUPDRS score and gait were observed.DiscussionAlthough preliminary, our results indicate that STN CR DBS can improve Parkinsonian gait together with other motor signs when stimulation parameters are properly selected. This study further supports the continued development of CR DBS as a novel therapy for PD and highlights the importance of parameter selection in its clinical application.https://www.frontiersin.org/articles/10.3389/fninf.2023.1185723/fullParkinson's diseasesubthalamic nucleuscoordinated resetgaitnon-human primate
spellingShingle Kai M. Bosley
Ziling Luo
Sana Amoozegar
Kit Acedillo
Kanon Nakajima
Luke A. Johnson
Jerrold L. Vitek
Jing Wang
Effect of subthalamic coordinated reset deep brain stimulation on Parkinsonian gait
Frontiers in Neuroinformatics
Parkinson's disease
subthalamic nucleus
coordinated reset
gait
non-human primate
title Effect of subthalamic coordinated reset deep brain stimulation on Parkinsonian gait
title_full Effect of subthalamic coordinated reset deep brain stimulation on Parkinsonian gait
title_fullStr Effect of subthalamic coordinated reset deep brain stimulation on Parkinsonian gait
title_full_unstemmed Effect of subthalamic coordinated reset deep brain stimulation on Parkinsonian gait
title_short Effect of subthalamic coordinated reset deep brain stimulation on Parkinsonian gait
title_sort effect of subthalamic coordinated reset deep brain stimulation on parkinsonian gait
topic Parkinson's disease
subthalamic nucleus
coordinated reset
gait
non-human primate
url https://www.frontiersin.org/articles/10.3389/fninf.2023.1185723/full
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