{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T03:00:10Z","timestamp":1790650810294,"version":"4.1.0"},"reference-count":40,"publisher":"BMJ","issue":"9","funder":[{"DOI":"10.13039\/100000864","name":"Michael J. Fox Foundation for Parkinson\u2019s Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000864","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Neurol Neurosurg Psychiatry"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the long-term effect of 60\u2009Hz stimulation of the subthalamic nucleus (STN) on dysphagia, freezing of gait (FOG) and other motor symptoms in patients with Parkinson\u2019s disease (PD) who have FOG at the usual 130\u2009Hz stimulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a prospective, sequence randomised, crossover, double-blind study. PD patients with medication refractory FOG at 130\u2009Hz stimulation of the STN were randomised to the sequences of 130\u2009Hz, 60\u2009Hz or deep brain stimulation off to assess swallowing function (videofluoroscopic evaluation and swallowing questionnaire), FOG severity (stand\u2013walk\u2013sit test and FOG questionnaire) and motor function (Unified PD Rating Scale, Part III motor examination (UPDRS-III)) at initial visit (V1) and follow-up visit (V2, after being on 60\u2009Hz stimulation for an average of 14.5 months), in their usual medications on state. The frequency of aspiration events, perceived swallowing difficulty and FOG severity at 60\u2009Hz compared with 130\u2009Hz stimulation at V2, and their corresponding changes at V2 compared with V1 at 60\u2009Hz were set as primary outcomes, with similar comparisons in UPDRS-III and its subscores as secondary outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All 11 enrolled participants completed V1 and 10 completed V2. We found the benefits of 60\u2009Hz stimulation compared with 130\u2009Hz in reducing aspiration frequency, perceived swallowing difficulty, FOG severity, bradykinesia and overall axial and motor symptoms at V1 and persistent benefits on all of them except dysphagia at V2, with overall decreasing efficacy when comparing V2 to V1.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The 60\u2009Hz stimulation, when compared with 130\u2009Hz, has long-term benefits on reducing FOG, bradykinesia and overall axial and motor symptoms except dysphagia, although the overall benefits decrease with long-term use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical trial registration<\/jats:title><jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"NCT02549859\" ext-link-type=\"clintrialgov\" specific-use=\"clinicaltrial pre-results\">NCT02549859<\/jats:ext-link>; Pre-results.<\/jats:p><\/jats:sec>","DOI":"10.1136\/jnnp-2018-318060","type":"journal-article","created":{"date-parts":[[2018,4,13]],"date-time":"2018-04-13T16:20:20Z","timestamp":1523636420000},"page":"989-994","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":78,"title":["Long-term effect of low frequency stimulation of STN on dysphagia, freezing of gait and other motor symptoms in PD"],"prefix":"10.1136","volume":"89","clinical-trial-number":[{"clinical-trial-number":"nct02549859","registry":"10.18810\/clinical-trials-gov","type":"preResults"},{"clinical-trial-number":"nct02549859","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Tao","family":"Xie","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Bloom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahesh","family":"Padmanaban","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Breanna","family":"Bertacchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjun","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"MacCracken","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abraham","family":"Dachman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Vigil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Satzer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy","family":"Zadikoff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katerina","family":"Markopoulou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Warnke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Un Jung","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,4,13]]},"reference":[{"key":"2020050722310728000_89.9.989.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa060281"},{"key":"2020050722310728000_89.9.989.2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2008.929"},{"key":"2020050722310728000_89.9.989.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0907083"},{"key":"2020050722310728000_89.9.989.4","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(10)70093-4"},{"key":"2020050722310728000_89.9.989.5","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181f61329"},{"key":"2020050722310728000_89.9.989.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa035275"},{"key":"2020050722310728000_89.9.989.7","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000159714.28232.C4"},{"key":"2020050722310728000_89.9.989.8","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/s40035-017-0083-7","article-title":"Effect of low versus high frequency stimulation on freezing of gait and other axial symptoms in Parkinson patients with bilateral STN DBS: a mini-review","volume":"6","author":"Xie","year":"2017","journal-title":"Transl Neurodegener"},{"key":"2020050722310728000_89.9.989.9","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000303972.16279.46"},{"key":"2020050722310728000_89.9.989.10","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000339385.187472.7d"},{"key":"2020050722310728000_89.9.989.11","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2011-302091"},{"key":"2020050722310728000_89.9.989.12","doi-asserted-by":"publisher","DOI":"10.1002\/mds.25810"},{"key":"2020050722310728000_89.9.989.13","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1111\/ner.12288","article-title":"Early use of 60\u2009hz frequency subthalamic stimulation in Parkinson\u2019s disease: a case series and review","volume":"18","author":"Ramdhani","year":"2015","journal-title":"Neuromodulation"},{"key":"2020050722310728000_89.9.989.14","doi-asserted-by":"publisher","DOI":"10.1002\/mds.23538"},{"key":"2020050722310728000_89.9.989.15","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/j.brs.2011.07.001","article-title":"Transient effects of 80 Hz stimulation on gait in STN DBS treated PD patients: a 15 months follow-up study","volume":"5","author":"Ricchi","year":"2012","journal-title":"Brain Stimul"},{"key":"2020050722310728000_89.9.989.16","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-013-6983-2"},{"key":"2020050722310728000_89.9.989.17","doi-asserted-by":"publisher","DOI":"10.1159\/000071231"},{"key":"2020050722310728000_89.9.989.18","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001184"},{"key":"2020050722310728000_89.9.989.19","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20324"},{"key":"2020050722310728000_89.9.989.20","doi-asserted-by":"publisher","DOI":"10.1016\/S0303-8467(97)00606-9"},{"key":"2020050722310728000_89.9.989.21","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.63.5.579"},{"key":"2020050722310728000_89.9.989.22","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1002\/ana.20525","article-title":"Calculating total electrical energy delivered by deep brain stimulation systems","volume":"58","author":"Koss","year":"2005","journal-title":"Ann Neurol"},{"key":"2020050722310728000_89.9.989.23","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1002\/mds.26861","article-title":"Comments on the recent viewpoint article on low-frequency deep brain stimulation for Parkinson\u2019s disease","volume":"32","author":"Xie","year":"2017","journal-title":"Mov Disord"},{"key":"2020050722310728000_89.9.989.24","doi-asserted-by":"crossref","unstructured":"Xie T , Padmanaban M . The effect of low frequency stimulation, with and without maintenance of the total electric energy delivered, on freezing of gait and other motor symptoms in PD patients who have freezing of gait at high frequency STN stimulation (P5.017). Neurology 2017;88.","DOI":"10.1212\/WNL.88.16_supplement.P5.017"},{"key":"2020050722310728000_89.9.989.25","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1002\/mds.26859","article-title":"Reply to: Comments on recent viewpoint article by Lazzaro di Biase and Alfonso Fasano titled \u201cLow-frequency deep brain stimulation for Parkinson\u2019s disease: great expectation or false hope?\u201d","volume":"32","author":"di Biase","year":"2017","journal-title":"Mov Disord"},{"key":"2020050722310728000_89.9.989.26","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/121.3.451"},{"key":"2020050722310728000_89.9.989.27","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.brs.2014.10.011","article-title":"Low-frequency versus high-frequency subthalamic nucleus deep brain stimulation on postural control and gait in Parkinson\u2019s disease: a quantitative study","volume":"8","author":"Vallabhajosula","year":"2015","journal-title":"Brain Stimul"},{"key":"2020050722310728000_89.9.989.28","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181c1ded6"},{"key":"2020050722310728000_89.9.989.29","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182a9f558"},{"key":"2020050722310728000_89.9.989.30","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1002\/mds.26837","article-title":"Sixty-hertz stimulation improves bradykinesia and amplifies subthalamic low-frequency oscillations","volume":"32","author":"Blumenfeld","year":"2017","journal-title":"Mov Disord"},{"key":"2020050722310728000_89.9.989.31","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1159\/000366066","article-title":"Subthalamic nucleus high-frequency stimulation for advanced Parkinson\u2019s disease: motor and neuropsychological outcome after 10 years","volume":"92","author":"Janssen","year":"2014","journal-title":"Stereotact Funct Neurosurg"},{"key":"2020050722310728000_89.9.989.32","doi-asserted-by":"publisher","DOI":"10.1016\/j.expneurol.2013.09.018"},{"key":"2020050722310728000_89.9.989.33","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1002\/mds.26229","article-title":"Subthalamic nucleus stimulation improves Parkinsonian gait via brainstem locomotor centers","volume":"30","author":"Weiss","year":"2015","journal-title":"Mov Disord"},{"key":"2020050722310728000_89.9.989.34","doi-asserted-by":"publisher","DOI":"10.1097\/01.wnr.0000187629.38010.12"},{"key":"2020050722310728000_89.9.989.35","doi-asserted-by":"publisher","DOI":"10.1097\/01.wnr.0000187637.20771.a0"},{"key":"2020050722310728000_89.9.989.36","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awl346"},{"key":"2020050722310728000_89.9.989.37","first-page":"283","article-title":"Arousal mechanisms related to posture and locomotion: 1. descending modulation","volume":"143","author":"Garcia-Rill","year":"2004","journal-title":"Prog Brain Res"},{"key":"2020050722310728000_89.9.989.38","doi-asserted-by":"publisher","DOI":"10.1016\/j.nurt.2007.10.067"},{"key":"2020050722310728000_89.9.989.39","doi-asserted-by":"publisher","DOI":"10.1002\/mds.10358"},{"key":"2020050722310728000_89.9.989.40","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21549"}],"container-title":["Journal of Neurology, Neurosurgery &amp; Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jnnp-2018-318060","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,6]],"date-time":"2024-07-06T00:33:40Z","timestamp":1720226020000},"score":1,"resource":{"primary":{"URL":"https:\/\/jnnp.bmj.com\/lookup\/doi\/10.1136\/jnnp-2018-318060"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,4,13]]},"references-count":40,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2018,8,17]]},"published-print":{"date-parts":[[2018,9]]}},"alternative-id":["10.1136\/jnnp-2018-318060"],"URL":"https:\/\/doi.org\/10.1136\/jnnp-2018-318060","relation":{},"ISSN":["0022-3050","1468-330X"],"issn-type":[{"value":"0022-3050","type":"print"},{"value":"1468-330X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,4,13]]}}}