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Mov Disord. 2016 Aug;31(8):1240-3. doi: 10.1002/mds.26669. Epub 2016 May 31.

Directional deep brain stimulation of the subthalamic nucleus: A pilot study using a novel neurostimulation device.

Author information

1
Department of Neurology, University Clinic of Würzburg, Würzburg, Germany.
2
Department of Neurosurgery, University Clinic of Würzburg, Würzburg, Germany.

Abstract

INTRODUCTION:

A novel neurostimulation system allows steering current in horizontal directions by combining segmented leads and multiple independent current control. The aim of this study was to evaluate directional DBS effects on parkinsonian motor features and adverse effects of subthalamic neurostimulation.

METHODS:

Seven PD patients implanted with the novel directional DBS system for bilateral subthalamic DBS underwent an extended monopolar review session during the first postoperative week, in which current thresholds were determined for rigidity control and stimulation-induced adverse effects using either directional or ring-mode settings.

RESULTS:

Effect or adverse effect thresholds were modified by directional settings for each of the 14 STN leads. Magnitude of change varied markedly between leads, as did orientation of optimal horizontal current steering.

CONCLUSION:

Directional current steering through chronically implanted segmented electrodes is feasible, alters adverse effect and efficacy thresholds in a highly individual manner, and expands the therapeutic window in a monopolar review as compared to ring-mode DBS. © 2016 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

KEYWORDS:

Parkinson's disease; deep brain stimulation

PMID:
27241197
PMCID:
PMC5089579
DOI:
10.1002/mds.26669
[Indexed for MEDLINE]
Free PMC Article

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