1. Pulse duration settings in subthalamic stimulation for Parkinson's disease.
- Author
-
Steigerwald F, Timmermann L, Kühn A, Schnitzler A, Reich MM, Kirsch AD, Barbe MT, Visser-Vandewalle V, Hübl J, van Riesen C, Groiss SJ, Moldovan AS, Lin S, Carcieri S, Manola L, and Volkmann J
- Subjects
- Aged, Biophysics, Double-Blind Method, Electrodes, Implanted, Female, Humans, Male, Middle Aged, Severity of Illness Index, Time Factors, Biophysical Phenomena physiology, Deep Brain Stimulation methods, Parkinson Disease therapy, Subthalamic Nucleus physiology
- Abstract
Background: Stimulation parameters in deep brain stimulation (DBS) of the subthalamic nucleus for Parkinson's disease (PD) are rarely tested in double-blind conditions. Evidence-based recommendations on optimal stimulator settings are needed. Results from the CUSTOM-DBS study are reported, comparing 2 pulse durations., Methods: A total of 15 patients were programmed using a pulse width of 30 µs (test) or 60 µs (control). Efficacy and side-effect thresholds and unified PD rating scale (UPDRS) III were measured in meds-off (primary outcome). The therapeutic window was the difference between patients' efficacy and side effect thresholds., Results: The therapeutic window was significantly larger at 30 µs than 60 µs (P = ·0009) and the efficacy (UPDRS III score) was noninferior (P = .00008)., Interpretation: Subthalamic neurostimulation at 30 µs versus 60 µs pulse width is equally effective on PD motor signs, is more energy efficient, and has less likelihood of stimulation-related side effects. © 2017 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society., (© 2017 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.)
- Published
- 2018
- Full Text
- View/download PDF