Frequency-dependent effects of subthalamic deep brain stimulation on motor symptoms in Parkinson’s disease: a meta-analysis of controlled trials

Abstract

This study aims to investigate how the frequency settings of deep brain stimulation (DBS) targeting the subthalamic nucleus (STN) influence the motor symptoms of Parkinson's disease (PD). Stimulation with frequencies less than 100 Hz (mostly 60 or 80 Hz) is considered low-frequency stimulation (LFS) and with frequencies greater than 100 Hz (mostly 130 or 150 Hz) is considered high-frequency stimulation (HFS). We conducted a comprehensive literature review and meta-analysis with a random-effect model. Ten studies with 132 patients were included in our analysis. The pooled results showed no significant difference in the total Unified Parkinson Disease Rating Scale part III (UPDRS-III) scores (mean effect, −1.50; p = 0.19) or the rigidity subscore between HFS and LFS. Compared to LFS, HFS induced greater reduction in the tremor subscore within the medication-off condition (mean effect, 1.01; p = 0.002), while no significance was shown within the medication-on condition (mean effect, 0.01; p = 0.92). LFS induced greater reduction in akinesia subscore (mean effect, −1.68, p = 0.003), the time to complete the stand-walk-sit (SWS) test (mean effect, −4.84; p < 0.00001), and the number of freezing of gait (FOG) (mean effect, −1.71; p = 0.03). These results suggest that two types of frequency settings may have different effects, that is, HFS induces better responses for tremor and LFS induces greater response for akinesia, gait, and FOG, respectively, which are worthwhile to be confirmed in future study, and will ultimately inform the clinical practice in the management of PD using STN-DBS.

Neurovascular coupling during deep brain stimulation

“…Clinically, stimulation frequencies in the 100e130 Hz range are typically used for DBS; however, a recent meta-analysis of controlled trials reported no therapeutic difference between 60 -80 Hz and 100e130 Hz [82]. In our experiments we selected stimulation frequencies in the range of 10e100 Hz, based on our previous paper where MCR saturated above 50 Hz [59].…”

Computational Modelling of Deep Brain Stimulation for Parkinson's Disease: A Critical Review

“…Yousif et al found significant variation in VTA across different DBS frequencies, and noted the importance of capturing the effects of DBS frequency as well as the resulting frequency of APs in targets such as the STN. Their statement that frequencies below 100 Hz worsen symptoms has been proven simplistic by subsequent studies such as those described in the meta-study by Su et al, which found differential effects in the HF and LF DBS ranges [10].…”

Neuromodulation of the Pineal Gland via Electrical Stimulation of Its Sympathetic Innervation Pathway

“…Frontiers in Neuroscience | www.frontiersin.org (Ngai et al, 1999;Stener-Victorin et al, 2006;Cakmak et al, 2008;Zhao, 2008;Liu et al, 2012;Su et al, 2018). Therefore, it is likely a frequency dependent effect exists in the stimulation of the pineal gland.…”