Parkinson Disease
Conditions
Keywords
Parkinson's disease, Freezing of gait, visual cue, auditory cue, subthalamic nucleus, deep brain stimulation
Brief summary
The investigators aims to assess the effectiveness of behavioral interventions based on sensory cues on freezing of gait in patients with Parkinson's disease after bilateral subthalamic nucleus deep brain stimulation.
Detailed description
Freezing of gait (FOG) leads to falling and is one of the major determinants of quality of life and prognosis in Parkinson's disease (PD). Previous evidence suggests that subthalamic nucleus deep brain stimulation (STN-DBS) improve off-medication FOG but not on-medication FOG in patients with PD. Furthermore, off-mediation FOG persist or even worsen after STN-DBS in some PD patients. Although visual and auditory cues are known to improve FOG in research setting, it is unclear whether these cues are effective for FOG in real clinical setting. Most previous studies have used wearable devices to use sensory cues, but such devices are difficult to apply in clinical practice. Therefore, this study aims to investigate the effectiveness of behavioral interventions based on visual and auditory cues in patients with PD after bilateral STN-DBS. Participants undergo clinical evaluations including the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Frontal Assessment Battery (FAB), Unified Parkinson 's Disease Rating Scale (UPDRS), Freezing of Gait-Questionnaire (FOG-Q), and the average number of falling over the last week. Then, participants receive behavior intervention training that includes how to apply visual and auditory cues to freezing of gait in real clinical practice. To investigate the education effect, FOG-Q and the average number of falling over the last week are repetitively assessed at 2-week and 4-week follow-ups using a phone call.
Interventions
BEHAVIORALbehavioral intervention based on sensory cues
Patients will receive behavior intervention training that includes how to apply visual and auditory cues to freezing of gait in real clinical practice.
Sponsors
Seoul National University Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
30 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients with Parkinson's disease who are aged 30 years or older * Patients who underwent bilateral subthalamic nucleus deep brain stimulation * Patients who complain of freezing of gait
Exclusion criteria
* Patients who have already used sensory cues for freezing of gait in clinical practice * Patients with MMSE scores of 18 or lower * Patients with Hoehn-Yahr scale 5 * Patients who have neurological symptoms associated with neurological disorders other than Parkinson's disease
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change from baseline to 4-week f/u in FOG-Q subscore (Q4+Q5+Q6) | baseline, after 4 weeks | The FOG-Q will be used to determine the efficacy of behavior intervention based on sensory cues. |
| Change from baseline to 4-week f/u in the number of falling | baseline, after 4 weeks | We will ask about the average number of falling over the last week at baseline and at 4-week f/u. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change from baseline to 4-week f/u in FOG-Q total score | baseline, after 4 weeks | The FOG-Q will be used to determine the efficacy of behavior intervention based on sensory cues. |
| Change from baseline to 2-week f/u in FOG-Q | baseline, after 2 weeks | The FOG-Q will be used to determine the efficacy of behavior intervention based on sensory cues. |
| Change from baseline to 2-week f/u in the number of falling | baseline, after 2 weeks | We will ask about the average number of falling over the last week at baseline and at 2-week f/u. |
| Change from baseline to 2-week f/u in FOG-Q subscore (Q4+Q5+Q6) | baseline, after 2 weeks | The FOG-Q will be used to determine the efficacy of behavior intervention based on sensory cues. |
Contacts
Primary ContactBeomseok Jeon, Professor
Outcome results
None listed