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xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EHigh-frequency deep brain stimulation (DBS) is effective for relief of Parkinson\u0027s disease (PD) symptoms. However, studies on the effect of subthalamic nucleus DBS (STN-DBS) on freezing of gait (FOG) have reported inconsistent results, with some suggesting that STN-DBS alleviates FOG [Davis JT et al. \u003Cem\u003EClin Neurol Neurosurg\u003C\/em\u003E 2006] and others reporting worsening of gait and balance [van Neunen BFL et al. \u003Cem\u003EMov Disord\u003C\/em\u003E 2008; Krack P et al. \u003Cem\u003EN Engl J Med\u003C\/em\u003E 2003]. This article discusses the the Vercise Implantable Stimulator for Treating Parkinson\u0027s Disease trial [VANTAGE; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT01221948\u0026amp;atom=%2Fspmdc%2F14%2F15%2F14.atom\u0022\u003ENCT01221948\u003C\/a\u003E].\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ENeurology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EExtrapyramidal \u0026amp; Movement Disorders\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ENeurology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EExtrapyramidal \u0026amp; Movement Disorders\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ENeurology\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EHigh-frequency deep brain stimulation (DBS) is effective for relief of Parkinson\u0027s disease (PD) symptoms. However, studies on the effect of subthalamic nucleus DBS (STN-DBS) on freezing of gait (FOG) have reported inconsistent results, with some suggesting that STN-DBS alleviates FOG [Davis JT et al. \u003Cem\u003EClin Neurol Neurosurg\u003C\/em\u003E 2006] and others reporting worsening of gait and balance [van Neunen BFL et al. \u003Cem\u003EMov Disord\u003C\/em\u003E 2008; Krack P et al. \u003Cem\u003EN Engl J Med\u003C\/em\u003E 2003].\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EThe objective of the Vercise Implantable Stimulator for Treating Parkinson\u0027s Disease trial [VANTAGE; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT01221948\u0026amp;atom=%2Fspmdc%2F14%2F15%2F14.atom\u0022\u003ENCT01221948\u003C\/a\u003E], presented by Michael T. Barbe, MD, University Hospital, Cologne, Germany, was to evaluate motor function improvement in patients with moderate to severe Parkinson\u0027s disease following treatment with bilateral STN-DBS. Prospective and nonrandomized, VANTAGE is open-label interventional trial in which a total of 40 patients underwent STN-DBS. DBS was delivered with the new Vercise DBS System, a multiplesource, eight-contact, constant-current system that is implantable and rechargeable.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EFOG was assessed before and after surgery with Unified Parkinson\u0027s Disease Rating Scale (UPDRS) II Item 14, the Freezing of Gait Questionnaire (FOGQ), and a videotaped walk test known to provoke FOG (with and without dual tasks). For the postsurgery tests, FOGQ was given at 26 weeks and the walking test at 12, 26, and 52 weeks after implantation. The patients were also assessed with the Core Assessment Program for Surgical Interventional Therapies motor tests, Tremor Rating Scale, Dyskinesia Rating Scale, Parkinson\u0027s Disease Questionnaire 39, Short Form 36 Health Survey, and the Schwab and England Activities of Daily Living Scale. Resource utilization was assessed and patient motor diaries collected over 3 days at all subsequent visits.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EThe cohort was 67.5% male and 32.5% female, with a mean age of 60.2 years. At baseline, 26 of the 38 patients (68%) had FOG. Duration of Parkinson\u0027s disease symptoms was 12.6 years in patients with FOG and 9.3 years in those without FOG. The total UPDRS, UPDRS III\u2013meds off, and UPDRS III\u2013meds on scores were similar between patients with and without FOG at baseline. At baseline, the L-dopa equivalent daily dose was 1305.0 mg in the group with FOG and 1653.6 mg in the group without.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EAt 26 weeks after surgery, the mean total FOGQ score was reduced by \u0026gt;50%. STN-DBS lowered the number of patients with FOG, as defined by FOGQ Item 4, from 26 of 38 patients at baseline to 13 of 38 patients at 26 weeks. The occurrence of FOG as measured with UPDRS II Item 14 declined over 52 weeks. UPDRS III Item 29 results showed that STN-DBS improved gait in this cohort over 52 weeks.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003ESTN-DBS significantly reduced FOG and improved gait in this cohort of patients with Parkinson\u0027s disease. Further analysis of the videotaped walking tests might provide additional insights into the effects of STN-DBS on FOG, especially with respect to potential changes in different FOG subtypes and patterns.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/15\/14.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzp4be\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}