Table 1
SARA assessments for DBS stimulation conditions.
| SARA ASSESSMENTS | BASELINE | SHAM | 10 HZ | 15 HZ | 30 HZ | SCORE RANGE |
|---|---|---|---|---|---|---|
| Gait | 6 | 6 | 6 | 6 | 6 | 0–8 |
| Stance | 2 | 2 | 2 | 2 | 2 | 0–6 |
| Sitting | 2 | 2 | 2 | 2 | 2 | 0–4 |
| Speech | 3 | 3 | 3 | 3 | 1 | 0–6 |
| Finger chase – right | 1 | 1 | 1 | 2 | 1 | 0–4 |
| Finger chase – left | 2 | 2 | 2 | 2 | 2 | 0–4 |
| Nose Finger – right | 2 | 2 | 2 | 3 | 2 | 0–4 |
| Nose Finger – left | 3 | 3 | 3 | 3 | 3 | 0–4 |
| Fast alternating movement – right | 2 | 2 | 2 | 1 | 1 | 0–4 |
| Fast alternating movement – left | 2 | 2 | 2 | 2 | 2 | 0–4 |
| Heel shin slides – right | 2 | 2 | 2 | 2 | 1 | 0–4 |
| Heel shin slides – left | 3 | 3 | 2 | 3 | 2 | 0–4 |
| Total | 21.5 | 21.5 | 21 | 22 | 18 |
Figure 1
Reconstruction of DBS electrodes and programming. (A) Coronal and axial sections of the patient’s MRI overlayed with the placement of the right and left DBS leads in the cZi, indicated as the red region. (B) Programming of the leads targeting the cZi, with monopolar activation of the right lead consisting of 70% L1 and 30% L2 ring mode contact, and the left lead consisting of 100% L1 contact. cZi caudal Zona incerta, STN subthalamic nucleus.
Figure 2
Ataxia and tremor assessments. (A) Postural sway area maps using APDM sensors with eyes open and feet apart for all conditions, demonstrating no drastic changes with the low-frequency stimulation as compared to baseline. (B) Similarly, with eyes closed and feet apart condition, no clear differences in sway measures were observed for the low- frequency stimulation conditions. (C-G) Speech audio spectrum for baseline, sham, 10 Hz, 15 Hz and 30 Hz stimulation conditions. (H) Acoustic voice quality index (AVQI) for all DBS stimulation conditions, depicting a reduction in AVQI for 30 Hz stimulation and showing an improvement in speech compared to other conditions. (I) A reduction in tremor amplitude was observed for the 30 Hz condition, as compared to baseline, sham and other low-frequency stimulation conditions. (J) Power spectral density (PSD) analysis also showed a reduction in spectral power at 30 Hz stimulation, indicating tremor reduction. Bsl baseline, Shm sham.