Neural Regeneration Research ›› 2018, Vol. 13 ›› Issue (2): 347-352.doi: 10.4103/1673-5374.226406

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Voltage adjustment improves rigidity and tremor in Parkinson’s disease patients receiving deep brain stimulation

Shao-hua Xu1, Chao Yang2, Wen-biao Xian1, Jing Gu3, Jin-long Liu2, Lu-lu Jiang1, Jing Ye1, 4, Yan-mei Liu1, Qi-yu Guo1, Yi-fan Zheng1, Lei Wu1,
Wan-ru Chen1, Zhong Pei1, Ling Chen1   

  1. 1 Department of Neurology, National Key Clinical Department and Key Discipline of Neurolory, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China
    2 Department of Neurosurgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
    3 Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong Province, China
    4 Department of Neurology, Tangshan Worker’s Hospital, Tangshan, Hebei Province, China
  • Received:2017-10-26 Online:2018-02-15 Published:2018-02-15
  • Contact: Ling Chen, M.D., Ph.D.,chenl2@mail.sysu.edu.cn.
  • Supported by:

    This study was supported by the Science and Technology Foundation of Guangdong Province of China, No. 2014A030304019; the Natural Science Foundation of Guangdong Province of China, No. 2015A030313164.

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Abstract:

Deep brain stimulation of the subthalamic nucleus is recognized as the most effective treatment for moderate and advanced Parkinson’s disease. Programming of the stimulation parameters is important for maintaining the efficacy of deep brain stimulation. Voltage is considered to be the most effective programming parameter. The present study is a retrospective analysis of six patients with Parkinson’s disease (four men and two women, aged 37–65 years), who underwent bilateral deep brain stimulation of the subthalamic nucleus at the First Affiliated Hospital of Sun Yat-sen University, China, and who subsequently adjusted only the stimulation voltage. We evaluated motor symptom severity using the Unified Parkinson’s Disease Rating Scale Part III, symptom progression using the Hoehn and Yahr scale, and the levodopa equivalent daily dose, before surgery and 1 and 2 years after surgery. The 2-year follow-up results show that rigidity and tremor improved, and clinical symptoms were reduced, while pulse width was maintained at 60 μs and frequency at 130 Hz. Voltage adjustment alone is particularly suitable for patients who cannot tolerate multiparameter program adjustment. Levodopa equivalent daily dose was markedly reduced 1 and 2 years after surgery compared with baseline. Our results confirm that rigidity, tremor and bradykinesia can be best alleviated by voltage adjustment. The trial was registered at ClinicalTrials.gov (identifier: NCT01934881).

Key words: nerve regeneration, deep brain stimulation, Parkinson’s disease, subthalamic nucleus, voltage, pulse width, frequency, tremor, rigidity, bradykinesia, axial symptoms, neural regeneration