Open AccessShort pulse width widens the therapeutic window of subthalamic neurostimulation
Author(s) -
Reich Martin M.,
Steigerwald Frank,
Sawalhe Anna D.,
Reese Rene,
Gunalan Kabilar,
Johannes Silvia,
Nickl Robert,
Matthies Cordula,
McIntyre Cameron C.,
Volkmann Jens
Publication year - 2015
Publication title -
annals of clinical and translational neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.824
H-Index - 42
ISSN - 2328-9503
DOI - 10.1002/acn3.168
Subject(s) - neurostimulation , medicine , therapeutic window , pulse (music) , stimulation , biomedical engineering , pulse width modulation , physical medicine and rehabilitation , voltage , physics , quantum mechanics , pharmacology
We explored the impact of pulse durations <60 μ sec on the therapeutic window of subthalamic neurostimulation in Parkinson's disease. Current thresholds for full rigidity control and first muscle contractions were evaluated at pulse durations between 20 and 120 μ sec during a monopolar review session in four patients. The average therapeutic window was 2.16 mA at 60 μ sec, which proportionally increased by 182% at 30 μ sec, while decreasing by 46% at 120 μ sec. Measured chronaxies and model data suggest, that pulse durations <60 μ sec lead to a focusing of the neurostimulation effect on smaller diameter axons close to the electrode while avoiding stimulation of distant pyramidal tract fibers.