Directional DBS the best option to improve gait, balance in Parkinson’s

A small clinical trial suggests that deep brain stimulation (DBS) targeting the central part of the subthalamic nucleus (STN), a brain region involved in movement, is the most effective option for improving balance and gait in Parkinson's disease, including freezing of gait. This approach outperformed DBS targeting the posterior STN and traditional nondirectional DBS in posture control and movement improvements. The study involved 10 patients with Parkinson’s who had gait and balance problems. Researchers compared central and posterior STN-DBS using directional electrical stimulation. Central STN-DBS significantly reduced freezing episodes, improved step length, and shortened turn duration compared to posterior STN-DBS. While nondirectional DBS also reduced freezing, central STN-DBS showed better overall outcomes, especially in posture control. After a 13-month follow-up with central STN-DBS, patients showed sustained improvements in dynamic and static posture and forward movement, with no severe adverse effects. Researchers concluded that central STN-DBS offers superior and lasting benefits for gait and postural issues in Parkinson's disease.