Freezing of Gait in Parkinson’s Disease Patients Treated with Bilateral Subthalamic Nucleus Deep Brain Stimulation: A Long-Term Overview
Giulia Di Rauso, Francesco Cavallieri, Isabella Campanini, Annalisa Gessani, Valentina Fioravanti, Alberto Feletti, Benedetta Damiano, Sara Scaltriti, Elisa Bardi, Maria Giulia Corni, Francesca Antonelli, Vittorio Rispoli, Francesca Cavalleri, Maria Angela Molinari, Sara Contardi, Elisa Menozzi, Annette Puzzolante, Jessica Rossi, Stefano Meletti, Giuseppe Biagini, Giacomo Pavesi, Valérie Fraix, Mirco Lusuardi, Alessandro Fraternali, Annibale Versari, Carla Budriesi, Elena Moro, Andrea Merlo, Franco Valzania
Abstract
Bilateral subthalamic nucleus deep brain stimulation (STN-DBS) is an effective treatment in advanced Parkinson’s Disease (PD). However, the effects of STN-DBS on freezing of gait (FOG) are still debated, particularly in the long-term follow-up (≥5-years). The main aim of the current study is to evaluate the long-term effects of STN-DBS on FOG. Twenty STN-DBS treated PD patients were included. Each patient was assessed before surgery through a detailed neurological evaluation, including FOG score, and revaluated in the long-term (median follow-up: 5-years) in different stimulation and drug conditions. In the long term follow-up, FOG score significantly worsened in the off-stimulation/off-medication condition compared with the pre-operative off-medication assessment (z = −1.930; p = 0.05) but not in the on-stimulation/off-medication (z = −0.357; p = 0.721). There was also a significant improvement of FOG at long-term assessment by comparing on-stimulation/off-medication and off-stimulation/off-medication conditions (z = −2.944; p = 0.003). These results highlight the possible beneficial long-term effects of STN-DBS on FOG.