Direct Substantia Nigra Deep Brain Stimulation in Parkinson's Disease: Efficacy, Safety, and the Frequency-Response Relationship.
Acute 130 Hz substantia nigra stimulation cut Parkinson's motor scores by nearly half
Direct Substantia Nigra Deep Brain Stimulation in Parkinson's Disease: Efficacy, Safety, and the Frequency-Response Relationship.
The substantia nigra (substantia nigra) is an emerging deep brain stimulation (deep brain stimulation) target for Parkinson's disease (PD).
Phase 1 comprised an acute randomized crossover assessment in which 30 participants underwent both substantia nigra stimulation at 10, 30, and 130 Hz and standard subthalamic nucleus stimulation at 130 Hz.
SN-DBS produced clear, frequency-dependent acute motor improvements.
The motor and spatial gait effects at 130 Hz were of similar magnitude to those observed with standard STN-DBS, while episodic memory performance remained stable across stimulation conditions.
Patient-specific VTA mapping identified an outcome-associated region predominantly within the dorsal substantia nigra, and greater spatial overlap was associated with greater motor improvement.
Direct substantia nigra stimulation produced a clear frequency-dependent acute response in PD, with 130 Hz yielding the strongest motor and spatial gait benefits among the tested frequencies and effects of similar magnitude to standard subthalamic nucleus stimulation.
VTA mapping localized the strongest response-associated region predominantly within the dorsal substantia nigra, and the 3-month observations provided a basis for further development of anatomically precise and individualized substantia nigra neuromodulation.