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

Publication date: Available online 21 July 2018

Source: Clinical Neurophysiology

Author(s): Éric Parmentier, Victor De Pasqua, Kévin D'Ostilio, Frédérique Depierreux, Gaëtan Garraux, Alain Maertens de Noordhout

Abstract

Objective

A network of cortical, subcortical and brainstem structures might be involved in freezing of gait (FOG). Subthalamic nucleus (STN) deep brain stimulation (DBS) could modulate this network. The audio-spinal reflex (ASR), reduced in PD, but increased by treatment, can be used to further investigate that locomotor network. The aim of this study is to find whether a correlation exists between ASR and FOG in PD patients under DBS.

Methods

In 14 PD patients with STN DBS and previous FOG, ASR was recorded, with DBS switched on and off. We also assessed FOG Questionnaire (FOGQ) and Unified Parkinson's Disease Rating Scale (UPDRS) Part III.

Results

Switching "on" DBS increased ASR amplitude (+ 33.2% with DBS ON, p=0.048). We also found a significant inverse correlation between FOGQ and modulation of ASR by DBS (r = -0.59, r² = 0.35, p<0.05).

Conclusions

This study shows that the incremental effect of DBS on ASR is greater in PD patients with less severe FOG.

Significance

This study shows a link between electrophysiological and clinical data about gait control. It might contribute to better understand why some DBS patients report heavy FOG and others do not. ASR might be used to evaluate or maybe predict the effect of stimulation parameters changes on FOG.

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