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Clinical response to varying the stimulus parameters in deep brain stimulation for essential tremor.

Publication ,  Journal Article
Kuncel, AM; Cooper, SE; Wolgamuth, BR; Clyde, MA; Snyder, SA; Montgomery, EB; Rezai, AR; Grill, WM
Published in: Movement disorders : official journal of the Movement Disorder Society
November 2006

Deep brain stimulation (DBS) of the ventral intermediate nucleus of the thalamus for essential tremor is sometimes limited by side effects. The mechanisms by which DBS alleviates tremor or causes side effects are unclear; thus, it is difficult to select stimulus parameters that maximize the width of the therapeutic window. The goal of this study was to quantify the impact on side effect intensity (SE), tremor amplitude, and the therapeutic window of varying stimulus parameters. Tremor amplitude and SE were recorded at 40 to 90 combinations of pulse width, frequency, and voltage across 14 thalami. Posterior variable inclusion probabilities indicated that frequency and voltage were the most important predictors of both SE and tremor amplitude. The amount of tremor suppression achieved at frequencies of 90 to 100 Hz was not different from that at 160 to 170 Hz. However, the width of the therapeutic window decreased significantly and power consumption increased as frequency was increased above 90 to 100 Hz. Improved understanding of the relationships between stimulus parameters and clinical responses may lead to improved techniques of stimulus parameter adjustment.

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Published In

Movement disorders : official journal of the Movement Disorder Society

DOI

EISSN

1531-8257

ISSN

0885-3185

Publication Date

November 2006

Volume

21

Issue

11

Start / End Page

1920 / 1928

Related Subject Headings

  • Regression Analysis
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Humans
  • Functional Laterality
  • Female
  • Essential Tremor
  • Dose-Response Relationship, Radiation
  • Deep Brain Stimulation
 

Citation

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Kuncel, A. M., Cooper, S. E., Wolgamuth, B. R., Clyde, M. A., Snyder, S. A., Montgomery, E. B., … Grill, W. M. (2006). Clinical response to varying the stimulus parameters in deep brain stimulation for essential tremor. Movement Disorders : Official Journal of the Movement Disorder Society, 21(11), 1920–1928. https://doi.org/10.1002/mds.21087
Kuncel, Alexis M., Scott E. Cooper, Barbara R. Wolgamuth, Merlise A. Clyde, Scott A. Snyder, Erwin B. Montgomery, Ali R. Rezai, and Warren M. Grill. “Clinical response to varying the stimulus parameters in deep brain stimulation for essential tremor.Movement Disorders : Official Journal of the Movement Disorder Society 21, no. 11 (November 2006): 1920–28. https://doi.org/10.1002/mds.21087.
Kuncel AM, Cooper SE, Wolgamuth BR, Clyde MA, Snyder SA, Montgomery EB, et al. Clinical response to varying the stimulus parameters in deep brain stimulation for essential tremor. Movement disorders : official journal of the Movement Disorder Society. 2006 Nov;21(11):1920–8.
Kuncel, Alexis M., et al. “Clinical response to varying the stimulus parameters in deep brain stimulation for essential tremor.Movement Disorders : Official Journal of the Movement Disorder Society, vol. 21, no. 11, Nov. 2006, pp. 1920–28. Epmc, doi:10.1002/mds.21087.
Kuncel AM, Cooper SE, Wolgamuth BR, Clyde MA, Snyder SA, Montgomery EB, Rezai AR, Grill WM. Clinical response to varying the stimulus parameters in deep brain stimulation for essential tremor. Movement disorders : official journal of the Movement Disorder Society. 2006 Nov;21(11):1920–1928.
Journal cover image

Published In

Movement disorders : official journal of the Movement Disorder Society

DOI

EISSN

1531-8257

ISSN

0885-3185

Publication Date

November 2006

Volume

21

Issue

11

Start / End Page

1920 / 1928

Related Subject Headings

  • Regression Analysis
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Humans
  • Functional Laterality
  • Female
  • Essential Tremor
  • Dose-Response Relationship, Radiation
  • Deep Brain Stimulation