CoEN5020 Advancing adaptive deep brain stimulation for gait disturbances and freezing of gait in Parkinson's disease

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Freezing of Gait (FoG) is characterized by sudden motor blocks during walking, and can occur with a wide variety of triggers such as extra cognitive load or during turning. This is a devastating symptom of Parkinson's disease (PD) effecting more than half of all patients. Associated with an increased risk of falls, fall-related injuries and mortality, it poses a major burden to patients and their families. Despite its significant health and socioeconomic impacts, FoG still represents a major therapeutic challenge in PD, as it is often unresponsive to dopaminergic medication or conventional continuous deep brain stimulation (DBS) of the subthalamic nucleus (STN) or globus pallidus internus (GPi). Inthis proposal, we aim to better understand the neural basis of FoG in PD with the aim to predict the likely occurrence of these transient FoG episodes, and to evaluate the effectiveness a novel biomimetic pattern of STN stimulation as a treatment promoting resistance to FoG. This would pave the way for early detection of episodic gait disturbances such as the onset of FoG that could be used to control switching between DBS stimulation patterns that are most appropriate for minimizing risk of falling at a given moment in time.