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

步态冻结（FoG）的特征是在行走过程中突然出现运动障碍，并且可以在多种触发因素下发生，例如额外的认知负荷或转弯时。这是帕金森病（PD）的一种破坏性症状，影响了一半以上的患者。它与跌倒、与跌倒有关的伤害和死亡的风险增加有关，给患者及其家属带来了重大负担。尽管其具有重要的健康和社会经济影响，但FoG仍然是PD治疗的主要挑战，因为它通常对多巴胺能药物或常规的丘脑下核（STN）或内白球（GPi）的持续深部脑刺激（DBS）无反应。在本研究中，我们旨在更好地了解PD中FoG的神经基础，以预测这些短暂性FoG发作的可能发生，并评估一种新的仿生STN刺激模式作为促进FoG抗性的治疗方法的有效性。这将为早期发现间歇性步态障碍铺平道路，如FoG的发作，可以用来控制在DBS刺激模式之间的切换，这种模式最适合在给定时刻将跌倒的风险降到最低。

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.