Short pulse width widens the therapeutic window of subthalamic neurostimulation

MM Reich, F Steigerwald, AD Sawalhe… - Annals of clinical …, 2015 - Wiley Online Library
MM Reich, F Steigerwald, AD Sawalhe, R Reese, K Gunalan, S Johannes, R Nickl…
Annals of clinical and translational neurology, 2015Wiley Online Library
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 …
Abstract
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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