Journal Article

FZJ-2020-01451

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Bipolar Directional Deep Brain Stimulation in Essential and Parkinsonian Tremor

Steffen, J. K. (Corresponding author) ; Reker, P. ; Mennicken, F. K. ; Dembek, T. A. ; Dafsari, H. S. ; Fink, G. R.FZJ* ; Visser‐Vandewalle, V. ; Barbe, M. T.

2020
Wiley-Blackwell Oxford [u.a.]

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Please use a persistent id in citations: http://hdl.handle.net/2128/25108  doi:10.1111/ner.13109

Abstract: ObjectiveTo compare directional monopolar, bipolar, and directional bipolar thalamic deep brain stimulation (DBS) in tremor patients.MethodsFourteen tremor patients (7 Essential Tremor and 7 Parkinson's Disease) implanted with directional DBS electrodes in the ventral intermediate nucleus (VIM) were enrolled. Side‐effect thresholds of monopolar directional stimulation (DIRECT) were compared to circular DBS as well as, in a randomized design, to those of two different bipolar stimulation settings (BIPOLAR = circular anode; BI‐DIRECT = directional anode). Tremor suppression (Tremor Rating Scale, TRS) right below the side‐effect threshold was also assessed.ResultsDirectional DBS in the individually best direction showed higher side‐effect thresholds than circular DBS (p = 0.0063). The thresholds were raised further using either one of the bipolar stimulation paradigms (BIPOLAR p = 0.0029, BI‐DIRECT p = 0.0022). The side‐effect thresholds did not differ between both bipolar settings, but side‐effects were less frequent with BI‐DIRECT. No difference in TRS scores with stimulation just below the side‐effect threshold was found between all stimulation conditions.ConclusionsSide‐effect thresholds of monopolar directional and bipolar stimulation with both circular and directional anodes were higher compared to traditional monopolar circular stimulation in the VIM. Bipolar DBS with directional anodes evoked side‐effect less frequently than bipolar and monopolar directional stimulation. All stimulation settings had comparable effects on tremor suppression just below their side‐effect thresholds. Thus, directional and different bipolar settings should be explored in patients with bothersome side‐effects of thalamic stimulation when monopolar stimulation settings are not satisfying. Further studies are needed to explore the efficiency of the different bipolar stimulation paradigms.

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Contributing Institute(s):

1. Kognitive Neurowissenschaften (INM-3)

Research Program(s):

1. 572 - (Dys-)function and Plasticity (POF3-572) (POF3-572)

Appears in the scientific report 2020

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Database coverage:
; ; ; Clarivate Analytics Master Journal List ; Ebsco Academic Search ; IF < 5 ; JCR ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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