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The Parkinson's-Reversing Breakthrough

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FIGURE 9 Changes in the Unified Parkinson's Disease Rating Scale for finger-tapping in the left-hand contralateral to the deep brain stimulation (DBS) lead and to the ipsilateral hand (right) in a single subject with Parkinson's disease and subthalamic nucleus DBS. The evaluator was blinded to the pattern of stimulation. The 130 pps DBS modulated at 2 Hz worsened motor performance (negative change in score), but regular DBS at 130 pps improved motor performance. Irregular DBS at 130 pps average did not have a marked effect.

FIGURE 9 Changes in the Unified Parkinson's Disease Rating Scale for finger-tapping in the left-hand contralateral to the deep brain stimulation (DBS) lead and to the ipsilateral hand (right) in a single subject with Parkinson's disease and subthalamic nucleus DBS. The evaluator was blinded to the pattern of stimulation. The 130 pps DBS modulated at 2 Hz worsened motor performance (negative change in score), but regular DBS at 130 pps improved motor performance. Irregular DBS at 130 pps average did not have a marked effect.

sisted of (i) muscle tone, (ii) finger-tapping speed, (iii) hand opening-closing speed, (iv) arm pronation-supination speed, (v) rest tremor, and (vi) postural tremor. Other measures in the UPDRS motor section could not be performed, because the patient was restricted to the operating table.

Computer programs controlled the stimulation patterns in which regular, irregular, and modulated 130-pps DBS was delivered (Fig. 8). The results of the stimulation are shown in Figure 9. For left-sided finger-tapping (contralateral to DBS), the greatest improvement was with regular stimulation and with stimulation modulated at 10 Hz, with the same overall stimulation frequency of 130 pps. All other stimulation patterns actually worsened finger-tapping. On the right side (ipsilateral to DBS), the only improvement was noted with regular stimulation. Thus, stimulation modulated at 5 and 2 Hz actually worsened finger-tapping, although the overall frequency was at the same high rate of 130 pps. Similar results were obtained for rapid left-hand opening and closing. The greatest improvement on the right-side DBS was with regular stimulation. Stimulation modulated at 10 Hz and 5 Hz produced some improvement, but stimulation modulated at 2 Hz produced no improvement in hand opening and closing. Stimulation at all patterns showed worsened performance on the right side that did not vary with stimulation pattern.

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