scholarly journals Case series: New‐onset freezing of gait in combined use of deep brain stimulation and Levodopa

2021 ◽  
Vol 9 (8) ◽  
Author(s):  
Mehri Salari ◽  
Zahra Aminzade ◽  
Reza Jalili khoshnood ◽  
Sepand Tehrani Fateh
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Freezing Of Gait ◽  
Case Series ◽  
Combined Use ◽  
Deep Brain ◽  
New Onset

scholarly journals Pedunculopontine Nucleus Deep Brain Stimulation for Parkinsonian Disorders: A Case Series

2020 ◽  
pp. 1-8
Author(s):  
Viswas Dayal ◽  
Ali Rajabian ◽  
Marjan Jahanshahi ◽  
Iciar Aviles-Olmos ◽  
Dorothy Cowie ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Freezing Of Gait ◽  
Case Series ◽  
Pedunculopontine Nucleus ◽  
Future Research ◽  
Patient Reported ◽  
Parkinsonian Disorders ◽  
Deep Brain ◽  
Diurnal Cycling

<b><i>Background:</i></b> Deep brain stimulation (DBS) of the pedunculopontine nucleus (PPN) has been investigated for the treatment of levodopa-refractory gait dysfunction in parkinsonian disorders, with equivocal results so far. <b><i>Objectives:</i></b> To summarize the clinical outcomes of PPN-DBS-treated patients at our centre and elicit any patterns that may guide future research. <b><i>Materials and Methods:</i></b> Pre- and post-operative objective overall motor and gait subsection scores as well as patient-reported outcomes were recorded for 6 PPN-DBS-treated patients, 3 with Parkinson’s disease (PD), and 3 with progressive supranuclear palsy (PSP). Electrodes were implanted unilaterally in the first 3 patients and bilaterally in the latter 3, using an MRI-guided MRI-verified technique. Stimulation was initiated at 20–30 Hz and optimized in an iterative manner. <b><i>Results:</i></b> Unilaterally treated patients did not demonstrate significant improvements in gait questionnaires, UPDRS-III or PSPRS scores or their respective gait subsections. This contrasted with at least an initial response in bilaterally treated patients. Diurnal cycling of stimulation in a PD patient with habituation to the initial benefit reproduced substantial improvements in freezing of gait (FOG) 3 years post-operatively. Among the PSP patients, 1 with a parkinsonian subtype had a sustained improvement in FOG while another with Richardson syndrome (PSP-RS) did not benefit. <b><i>Conclusions:</i></b> PPN-DBS remains an investigational treatment for levodopa-refractory FOG. This series corroborates some previously reported findings: bilateral stimulation may be more effective than unilateral stimulation; the response in PSP patients may depend on the disease subtype; and diurnal cycling of stimulation to overcome habituation merits further investigation.

Subthalamic nucleus deep brain stimulation for the treatment of secondary dystonia: A case series and review of literature

2017 ◽  
Vol 10 (4) ◽  
pp. 870-872 ◽  
Author(s):  
Jason Margolesky ◽  
Nathan Schoen ◽  
Walter Jermakowicz ◽  
Samir Sur ◽  
Iahn Cajigas ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Subthalamic Nucleus ◽  
Brain Stimulation ◽  
Case Series ◽  
Review Of Literature ◽  
Secondary Dystonia ◽  
Deep Brain

Correlation between deep brain stimulation effects on freezing of gait and audio-spinal reflex

2018 ◽  
Vol 129 (10) ◽  
pp. 2083-2088 ◽  
Author(s):  
Éric Parmentier ◽  
Victor De Pasqua ◽  
Kévin D'Ostilio ◽  
Frédérique Depierreux ◽  
Gaëtan Garraux ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Freezing Of Gait ◽  
Spinal Reflex ◽  
Deep Brain

Freezing of Gait After Bilateral Globus Pallidus Interna Deep Brain Stimulation in Generalized Dystonia

2020 ◽  
pp. 105-108
Author(s):  
Mariana Moscovich
Keyword(s):  
Deep Brain Stimulation ◽  
Globus Pallidus ◽  
Brain Stimulation ◽  
Freezing Of Gait ◽  
Left Handed ◽  
Old Left ◽  
Generalized Dystonia ◽  
Walking Difficulty ◽  
Deep Brain

Deep brain stimulation (DBS) of the globus pallidus internus (GPi) is a safe and long-term effective treatment for medication-refractory dystonia. However, complications and side effects may occur. Freezing of gait (FOG) is a rare phenomenon in patients with dystonia, although very frequently this complication is observed in patients with Parkinson disease (PD). FOG can be disabling and may severely impair quality of life, even when episodic. This chapter reports on a case of a 49-year-old left-handed man presenting with FOG, impairment in balance, and walking difficulty. These issues emerged 3 years after successful bilateral GPi DBS for primary generalized dystonia.

scholarly journals Intestinal Levodopa/Carbidopa Infusion as a Therapeutic Option for Unresponsive Freezing of Gait after Deep Brain Stimulation in Parkinson’s Disease

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Belén González-Herrero ◽  
Serge Jauma-Classen ◽  
Roser Gómez-Llopico ◽  
Gerard Plans ◽  
Matilde Calopa
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Subthalamic Nucleus ◽  
Brain Stimulation ◽  
Rating Scale ◽  
Therapeutic Option ◽  
Freezing Of Gait ◽  
Disease Rating ◽  
Deep Brain

Background. Treatment of freezing of gait (FOG) is always challenging because of its unpredictable nature and multifactorial physiopathology. Intestinal levodopa infusion has been proposed in recent years as a valuable option for its improvement. FOG in Parkinson’s disease (PD) can appear after deep brain stimulation in patients who never had gait symptoms. Objective. To study the effects of intestinal levodopa/carbidopa infusion in unresponsive-FOG that appears in PD patients treated with subthalamic nucleus deep brain stimulation. Methods. We retrospectively collected and analyzed demographic, clinical, and therapeutic data from five PD patients treated with subthalamic nucleus stimulation who developed unresponsive-FOG and received intestinal levodopa/carbidopa infusion as an alternative therapy. FOG was measured based on scores in item 14 of the Unified Parkinson’s Disease Rating Scale before and after intestinal levodopa infusion. Results. Administration of intestinal levodopa caused improvement of FOG in the “ON” state in four patients (80%) by 2 or more points in item 14 of the Unified Parkinson’s Disease Rating Scale. The improvement was maintained for at least 12 months. Conclusions. Intestinal levodopa infusion may be a valuable therapeutic option for unresponsive-FOG developed after subthalamic nucleus deep brain stimulation.

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