Short pulse width widens the therapeutic window of subthalamic neurostimulation

We explored the impact of pulse durations <60 μsec 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 μsec during a monopolar review...

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Autores principales: Reich, Martin M, Steigerwald, Frank, Sawalhe, Anna D, Reese, Rene, Gunalan, Kabilar, Johannes, Silvia, Nickl, Robert, Matthies, Cordula, McIntyre, Cameron C, Volkmann, Jens
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BlackWell Publishing Ltd 2015
Materias:
Brief Communications
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4402087/
https://www.ncbi.nlm.nih.gov/pubmed/25909087
http://dx.doi.org/10.1002/acn3.168
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author Reich, Martin M
Steigerwald, Frank
Sawalhe, Anna D
Reese, Rene
Gunalan, Kabilar
Johannes, Silvia
Nickl, Robert
Matthies, Cordula
McIntyre, Cameron C
Volkmann, Jens
author_facet Reich, Martin M
Steigerwald, Frank
Sawalhe, Anna D
Reese, Rene
Gunalan, Kabilar
Johannes, Silvia
Nickl, Robert
Matthies, Cordula
McIntyre, Cameron C
Volkmann, Jens
author_sort Reich, Martin M
collection PubMed
description We explored the impact of pulse durations <60 μsec 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 μsec during a monopolar review session in four patients. The average therapeutic window was 2.16 mA at 60 μsec, which proportionally increased by 182% at 30 μsec, while decreasing by 46% at 120 μsec. Measured chronaxies and model data suggest, that pulse durations <60 μsec lead to a focusing of the neurostimulation effect on smaller diameter axons close to the electrode while avoiding stimulation of distant pyramidal tract fibers.
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spelling pubmed-44020872015-04-23 Short pulse width widens the therapeutic window of subthalamic neurostimulation Reich, Martin M Steigerwald, Frank Sawalhe, Anna D Reese, Rene Gunalan, Kabilar Johannes, Silvia Nickl, Robert Matthies, Cordula McIntyre, Cameron C Volkmann, Jens Ann Clin Transl Neurol Brief Communications We explored the impact of pulse durations <60 μsec 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 μsec during a monopolar review session in four patients. The average therapeutic window was 2.16 mA at 60 μsec, which proportionally increased by 182% at 30 μsec, while decreasing by 46% at 120 μsec. Measured chronaxies and model data suggest, that pulse durations <60 μsec lead to a focusing of the neurostimulation effect on smaller diameter axons close to the electrode while avoiding stimulation of distant pyramidal tract fibers. BlackWell Publishing Ltd 2015-04 2015-01-31 /pmc/articles/PMC4402087/ /pubmed/25909087 http://dx.doi.org/10.1002/acn3.168 Text en © 2015 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals, Inc on behalf of American Neurological Association. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
spellingShingle Brief Communications
Reich, Martin M
Steigerwald, Frank
Sawalhe, Anna D
Reese, Rene
Gunalan, Kabilar
Johannes, Silvia
Nickl, Robert
Matthies, Cordula
McIntyre, Cameron C
Volkmann, Jens
Short pulse width widens the therapeutic window of subthalamic neurostimulation
title Short pulse width widens the therapeutic window of subthalamic neurostimulation
title_full Short pulse width widens the therapeutic window of subthalamic neurostimulation
title_fullStr Short pulse width widens the therapeutic window of subthalamic neurostimulation
title_full_unstemmed Short pulse width widens the therapeutic window of subthalamic neurostimulation
title_short Short pulse width widens the therapeutic window of subthalamic neurostimulation
title_sort short pulse width widens the therapeutic window of subthalamic neurostimulation
topic Brief Communications
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4402087/
https://www.ncbi.nlm.nih.gov/pubmed/25909087
http://dx.doi.org/10.1002/acn3.168
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