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@ARTICLE{Barbe:139912,
      author       = {Barbe, Michael and Dembek, T. and Becker, J. and Raethjen,
                      J. and Hartinger, M. and Meister, I. and Runge, M. and
                      Maarouf, M. and Fink, Gereon Rudolf and Timmermann, L.},
      title        = {{I}ndividualized current-shaping reduces {DBS}-induced
                      dysarthria in patients with essential tremor},
      journal      = {Neurology},
      volume       = {82},
      number       = {7},
      issn         = {0028-3878},
      address      = {Hagerstown, Md.},
      publisher    = {Lippincott Williams $\&$ Wilkins},
      reportid     = {FZJ-2013-05881},
      pages        = {614-619},
      year         = {2014},
      abstract     = {Objective: To investigate in patients with essential tremor
                      (ET) treated with thalamic/subthalamic deep brain
                      stimulation (DBS) whether stimulation-induced dysarthria
                      (SID) can be diminished by individualized current-shaping
                      with interleaving stimulation (cs-ILS) while maintaining
                      tremor suppression (TS).Methods: Of 26 patients screened, 10
                      reported SID and were invited for testing. TS was assessed
                      by the Tremor Rating Scale and kinematic analysis of
                      postural and action tremor. SID was assessed by phonetic and
                      logopedic means. Additionally, patients rated their
                      dysarthria on a visual analog scale.Results: In 6 of the 10
                      patients with ET, DBS-ON (relative to DBS-OFF) led to SID
                      while tremor was successfully reduced. When comparing
                      individualized cs-ILS with a non–current-shaped
                      interleaving stimulation (ILS) in these patients, there was
                      no difference in TS while 4 of the 6 patients showed
                      subjective improvement of speech during cs-ILS. Phonetic
                      analysis (ILS vs cs-ILS) revealed that during cs-ILS there
                      was a reduction of voicing during the production of
                      voiceless stop consonants and also a trend toward an
                      improvement in oral diadochokinetic rate, reflecting less
                      dysarthria. Logopedic rating showed a trend toward
                      deterioration in the diadochokinesis task when comparing ON
                      with OFF but no difference between ILS and
                      cs-ILS.Conclusion: This is a proof-of-principle evaluation
                      of current-shaping in patients with ET treated with
                      thalamic/subthalamic DBS and experiencing SID. Data suggest
                      a benefit on SID from individual shaping of current spread
                      while TS is preserved.Classification of evidence: This study
                      provides Class IV evidence that in patients with ET treated
                      with DBS with SID, individualized cs-ILS reduces dysarthria
                      while maintaining tremor control.},
      cin          = {INM-3},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-3-20090406},
      pnm          = {333 - Pathophysiological Mechanisms of Neurological and
                      Psychiatric Diseases (POF2-333) / 89572 - (Dys-)function and
                      Plasticity (POF2-89572)},
      pid          = {G:(DE-HGF)POF2-333 / G:(DE-HGF)POF2-89572},
      typ          = {PUB:(DE-HGF)16},
      UT           = {WOS:000336498300013},
      pubmed       = {pmid:24443448},
      doi          = {10.1212/WNL.0000000000000127},
      url          = {https://juser.fz-juelich.de/record/139912},
}