{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:52:34Z","timestamp":1787017954842,"version":"build-2736575974"},"reference-count":76,"publisher":"S. Karger AG","issue":"4","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Stereotact Funct Neurosurg"],"abstract":"<jats:p>Introduction: Freezing of gait (FOG) in advanced Parkinson\u2019s disease (PD) remains a therapeutic challenge, with conventional subthalamic nucleus deep brain stimulation (STN-DBS) demonstrating limited efficacy. Methods: This multicenter, prospective, single-blind study investigated the effects of combined high-frequency STN stimulation and ultra-low-frequency substantia nigra pars reticulata (SNr) stimulation in six PD patients with refractory FOG. Assessments included Movement Disorder Society-Sponsored Revision of the Unified Parkinson\u2019s Disease Rating Scale (MDS-UPDRS) Part III, New Freezing of Gait Questionnaire (NFOGQ), Gait and Falls Questionnaire (GFQ), and Schwab and England Activities of Daily Living (ADL) scale. Results: Dual-target stimulation significantly outperformed STN-only stimulation in improving appendicular motor symptoms (MDS-UPDRS Part III: p = 0.04 medication-ON, p = 0.009 medication-OFF) and reducing FOG severity (NFOGQ: p = 0.02, GFQ: p = 0.01 vs. STN-DBS). Postural stability remained unchanged, while ADL scores improved clinically (p = 0.04). Volume of tissue activated (VTA) analysis revealed more STN VTA connectivity in cerebrum, in contrast with more SNr VTA connectivity in cerebellum. Conclusion: These findings highlight the potential of dual-target free-frequency DBS for multimodal symptom control in PD and hopefully bring new sights in understanding mechanisms of DBS treatments in FOG.<\/jats:p>","DOI":"10.1159\/000549859","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T17:01:00Z","timestamp":1768842060000},"page":"256-267","source":"Crossref","is-referenced-by-count":1,"title":["Simultaneous High-Frequency Subthalamic and Ultra-Low-Frequency Nigral Deep Brain Stimulation Improved Motor Symptoms and Freezing of Gait in Parkinson\u2019s 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