Abstract
Subthalamic nucleus deep brain stimulation (STN-DBS) is an established treatment for selected Parkinson's disease (PD) patients, but therapy is often limited by side effects. Previous studies indicate an inverse relationship of the therapeutic window (TW) to pulse width (PW) settings down to 60μs, but there is limited data available on the effect of shorter PWs. To define the TW of STN-DBS in PD at PW of 30μs (PW30) relative to standard PW settings at 60μs (PW60), and to compare speed of gait and speech intelligibility on the two PW conditions. Monopolar review data of 15 consecutive PD patients who had screening of contacts performed at PW60 and PW30 was used to calculate the TW at each contact. We compared the TWs of the most efficacious contact per STN, and a secondary analysis was performed comparing all contacts. Speed of gait with a timed 10 metre walk test, speech intelligibility, and perceptual characteristics of speech were also compared at the efficacy thresholds for PW60 and PW30. The TW was significantly greater at PW30 [3.8±1.6mA] than at PW60 [1.7±1.1mA]. In the secondary analysis, 110 TWs could be calculated and these remained significantly higher at PW30. The timed 10 metre walk at PW30 was faster than at PW60, ...Continue Reading
References
Sep 1, 1969·Journal of Speech and Hearing Research·F L DarleyJ R Brown
Jan 14, 1995·Lancet·P LimousinA L Benabid
Oct 15, 1998·The New England Journal of Medicine·P LimousinA L Benabid
Jul 19, 2001·Journal of Neurology, Neurosurgery, and Psychiatry·M RizzoneL Lopiano
Sep 11, 2002·Neurology·E MoroP Pollak
Dec 14, 2004·Movement Disorders : Official Journal of the Movement Disorder Society·Anna Lena TörnqvistStig Rehncrona
Jun 29, 2005·Annals of Neurology·Adam M KossJay L Shils
Jul 1, 2006·Movement Disorders : Official Journal of the Movement Disorder Society·Jens VolkmannRajesh Pahwa
Jul 1, 2006·Movement Disorders : Official Journal of the Movement Disorder Society·Günther DeuschlValerie Voon
Aug 8, 2006·Movement Disorders : Official Journal of the Movement Disorder Society·Galit Kleiner-FismanGünther Deuschl
Oct 12, 2007·Journal of Neurology, Neurosurgery, and Psychiatry·G TommasiP Pollak
Jan 8, 2009·JAMA : the Journal of the American Medical Association·Frances M WeaverUNKNOWN CSP 468 Study Group
Jun 24, 2010·Journal of Neurology, Neurosurgery, and Psychiatry·T FoltynieP Limousin
Nov 12, 2010·Neurology·E TripolitiP Limousin
Nov 26, 2010·Neurosurgery·Etienne M HollLudvic Zrinzo
Nov 28, 2013·Brain : a Journal of Neurology·Sergiu GroppaJens Volkmann
May 3, 2014·Journal of Neurology, Neurosurgery, and Psychiatry·Iciar Aviles-OlmosPatricia Limousin
Apr 25, 2015·Annals of Clinical and Translational Neurology·Martin M ReichJens Volkmann
Jan 26, 2016·Parkinsonism & Related Disorders·José Fidel Baizabal-Carvallo, Joseph Jankovic
Jul 18, 2017·NeuroImage·Harith AkramLudvic Zrinzo
Citations
Oct 2, 2019·Movement Disorders : Official Journal of the Movement Disorder Society·Viswas DayalThomas Foltynie
Apr 7, 2020·Expert Review of Medical Devices·Antonella MacerolloPatricia Limousin
Jun 25, 2019·Frontiers in Neurology·Thomas KoeglspergerKai Bötzel
Sep 27, 2020·Movement Disorders : Official Journal of the Movement Disorder Society·Viswas DayalThomas Foltynie
Sep 4, 2019·Nature Biotechnology·Hayriye CagnanPeter Brown
Apr 20, 2020·Revue neurologique·T WirthS Thobois
Apr 20, 2020·Revue neurologique·M AubignatP Krystkowiak
Jun 1, 2021·Journal of Parkinson's Disease·Aline SegerMonika Pötter-Nerger
May 26, 2021·Parkinsonism & Related Disorders·Margherita FabbriMaurizio Zibetti
Feb 12, 2020·Stereotactic and Functional Neurosurgery·Viswas DayalThomas Foltynie
Jan 4, 2020·Journal of Neurosurgery·Tariq ParkerTipu Z Aziz