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Ann Clin Transl Neurol. 2015 Apr;2(4):427-32. doi: 10.1002/acn3.168. Epub 2015 Jan 31.

Short pulse width widens the therapeutic window of subthalamic neurostimulation.

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Department of Neurology, Julius-Maximilians-University Würzburg, Germany.
Department of Biomedical Engineering, Case Western Reserve University Cleveland, Ohio.
Department of Neurosurgery, Julius-Maximilans-University Würzburg, Germany.


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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