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CASE REPORT article

Front. Bioeng. Biotechnol.
Sec. Biomechanics
Volume 12 - 2024 | doi: 10.3389/fbioe.2024.1428189

Case report: Improvement of gait with adaptive deep brain stimulation in a patient with Parkinson's disease

Provisionally accepted
Ioannis U. Isaias Ioannis U. Isaias 1,2,3*Laura Caffi Laura Caffi 1,2,3,4Linda Borellini Linda Borellini 5Antonella Ampollini Antonella Ampollini 5Marco Locatelli Marco Locatelli 5Gianni Pezzoli Gianni Pezzoli 1Alberto Mazzoni Alberto Mazzoni 4,6Chiara Palmisano Chiara Palmisano 1,2,3
  • 1 Parkinson Institute, Milan, Milan, Lombardy, Italy
  • 2 University Hospital Würzburg, Würzburg, Bavaria, Germany
  • 3 Julius Maximilian University of Würzburg, Würzburg, Bavaria, Germany
  • 4 Institute of BioRobotics, Sant'Anna School of Advanced Studies, Pontedera, Italy
  • 5 IRCCS Ca 'Granda Foundation Maggiore Policlinico Hospital, Milan, Lombardy, Italy
  • 6 Department of Excellence in Robotics and AI, Sant'Anna School of Advanced Studies, Pisa, Tuscany, Italy

The final, formatted version of the article will be published soon.

    Gait disturbance is a common and severe symptom of Parkinson’s disease that severely impairs quality of life. Current treatments provide only partial benefits with wide variability in outcomes. Also, deep brain stimulation of the subthalamic nucleus (STN-DBS), a mainstay treatment for bradykinetic-rigid symptoms and parkinsonian tremor, is poorly effective on gait. We applied a novel DBS paradigm, adjusting the current amplitude linearly with respect to subthalamic beta power (adaptive DBS), in one parkinsonian patient with gait impairment and chronically stimulated with conventional DBS. We studied the kinematics of gait and gait initiation (anticipatory postural adjustments) as well as subthalamic beta oscillations with both conventional and adaptive DBS. With adaptive DBS, the patient showed a consistent and long-lasting improvement in walking while retaining benefits on other disease-related symptoms. We suggest that adaptive DBS can benefit gait in Parkinson’s disease possibly by avoiding overstimulation and dysfunctional entrainment of the supraspinal locomotor network.

    Keywords: Adaptive deep brain stimulation, Parkinson's disease, Gait, Subthalamic Nucleus, Local Field Potentials

    Received: 05 May 2024; Accepted: 12 Aug 2024.

    Copyright: © 2024 Isaias, Caffi, Borellini, Ampollini, Locatelli, Pezzoli, Mazzoni and Palmisano. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Ioannis U. Isaias, Parkinson Institute, Milan, Milan, Lombardy, Italy

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.