Parkinson Disease Clinical Trial
Official title:
Evaluate the Effectiveness and Safety of Variable Frequency Stimulation Compared With Constant Frequency Stimulation for Patients With Idiopathic Parkinson's Disease(RESTEP Study)
In the VFS paradigm the stimulation frequency was set to alternate between high and low frequencies, where the frequency of stimulation or frequency combinations can be changed instantaneously according to damage of the moment rhythms. Variable frequency stimulation is a novel dynamic therapy which breaks through the existing single high-frequency stimulation paradigms. It is the world's first VFS therapy for the brain.
In advanced stages of PD, motor symptoms and dyskinesia are effectively treated by deep brain
stimulation (DBS) targeting the subthalamic nucleus (STN) . Traditionally, in this procedure,
stimulation is set to a constant frequency electrical stimulation with the physician
programming the parameters of stimulation frequency, pulse width and amplitude, and
stimulated patients' brain nuclei with single frequency, single pulse width and single
amplitude of the electric stimulation. Indeed, high frequency stimulation (HFS) of the STN
provides consistent, long-term improvement of the cardinal signs of PD . However, the
treatment effects of HFS on the axial symptoms of PD, specifically FOG can be poor often
causing further impairment. While this can be alleviated by using relatively low frequency
stimulation (LFS) , major concerns in the clinical application of LFS exist in regards to its
duration of therapeutic benefit. Previous studies have shown that LFS of the STN improves the
axial motor signs in some PD patients, but a loss of therapeutic efficacy is seen in the
short term. Thereafter, patients may present increased tremor, rigidity and bradykinesia,
which is often intolerable outweighing the initial benefits of LFS therapy for FOG. As such,
a suitable treatment strategy for FOG remains to be established.
Based on previous findings on the relationships between stimulation frequency and movement
rhythm regulation in the human body, The National Engineering Laboratory for Neuromodulation,
Tsinghua University, proposes a method of variable frequency stimulation (VFS) for aiding
movement.
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