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Directional deep brain stimulation of the subthalamic nucleus: A pilot study using a novel neurostimulation device
Author(s) -
Steigerwald Frank,
Müller Lorenz,
Johannes Silvia,
Matthies Cordula,
Volkmann Jens
Publication year - 2016
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.26669
Subject(s) - neurostimulation , deep brain stimulation , subthalamic nucleus , transcranial direct current stimulation , essential tremor , physical medicine and rehabilitation , medicine , stimulation , neuroscience , psychology , parkinson's disease , disease , pathology
A novel neurostimulation system allows steering current in horizontal directions by combining segmented leads and multiple independent current control. The aim of this study was to evaluate directional DBS effects on parkinsonian motor features and adverse effects of subthalamic neurostimulation. Methods Seven PD patients implanted with the novel directional DBS system for bilateral subthalamic DBS underwent an extended monopolar review session during the first postoperative week, in which current thresholds were determined for rigidity control and stimulation‐induced adverse effects using either directional or ring‐mode settings. Results Effect or adverse effect thresholds were modified by directional settings for each of the 14 STN leads. Magnitude of change varied markedly between leads, as did orientation of optimal horizontal current steering. Conclusion Directional current steering through chronically implanted segmented electrodes is feasible, alters adverse effect and efficacy thresholds in a highly individual manner, and expands the therapeutic window in a monopolar review as compared to ring‐mode DBS. © 2016 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society