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Stimulus features underlying reduced tremor suppression with temporally patterned deep brain stimulation.

Publication ,  Journal Article
Birdno, MJ; Kuncel, AM; Dorval, AD; Turner, DA; Gross, RE; Grill, WM
Published in: J Neurophysiol
January 2012

Deep brain stimulation (DBS) provides dramatic tremor relief when delivered at high-stimulation frequencies (more than ∼100 Hz), but its mechanisms of action are not well-understood. Previous studies indicate that high-frequency stimulation is less effective when the stimulation train is temporally irregular. The purpose of this study was to determine the specific characteristics of temporally irregular stimulus trains that reduce their effectiveness: long pauses, bursts, or irregularity per se. We isolated these characteristics in stimulus trains and conducted intraoperative measurements of postural tremor in eight volunteers. Tremor varied significantly across stimulus conditions (P < 0.015), and stimulus trains with pauses were significantly less effective than stimulus trains without (P < 0.002). There were no significant differences in tremor between trains with or without bursts or between trains that were irregular or periodic. Thus the decreased effectiveness of temporally irregular DBS trains is due to long pauses in the stimulus trains, not the degree of temporal irregularity alone. We also conducted computer simulations of neuronal responses to the experimental stimulus trains using a biophysical model of the thalamic network. Trains that suppressed tremor in volunteers also suppressed fluctuations in thalamic transmembrane potential at the frequency associated with cerebellar burst-driver inputs. Clinical and computational findings indicate that DBS suppresses tremor by masking burst-driver inputs to the thalamus and that pauses in stimulation prevent such masking. Although stimulation of other anatomic targets may provide tremor suppression, we propose that the most relevant neuronal targets for effective tremor suppression are the afferent cerebellar fibers that terminate in the thalamus.

Duke Scholars

Published In

J Neurophysiol

DOI

EISSN

1522-1598

Publication Date

January 2012

Volume

107

Issue

1

Start / End Page

364 / 383

Location

United States

Related Subject Headings

  • Tremor
  • Thalamus
  • Neurology & Neurosurgery
  • Neural Pathways
  • Neural Inhibition
  • Nerve Net
  • Motor Cortex
  • Models, Neurological
  • Middle Aged
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Birdno, M. J., Kuncel, A. M., Dorval, A. D., Turner, D. A., Gross, R. E., & Grill, W. M. (2012). Stimulus features underlying reduced tremor suppression with temporally patterned deep brain stimulation. J Neurophysiol, 107(1), 364–383. https://doi.org/10.1152/jn.00906.2010
Birdno, Merrill J., Alexis M. Kuncel, Alan D. Dorval, Dennis A. Turner, Robert E. Gross, and Warren M. Grill. “Stimulus features underlying reduced tremor suppression with temporally patterned deep brain stimulation.J Neurophysiol 107, no. 1 (January 2012): 364–83. https://doi.org/10.1152/jn.00906.2010.
Birdno MJ, Kuncel AM, Dorval AD, Turner DA, Gross RE, Grill WM. Stimulus features underlying reduced tremor suppression with temporally patterned deep brain stimulation. J Neurophysiol. 2012 Jan;107(1):364–83.
Birdno, Merrill J., et al. “Stimulus features underlying reduced tremor suppression with temporally patterned deep brain stimulation.J Neurophysiol, vol. 107, no. 1, Jan. 2012, pp. 364–83. Pubmed, doi:10.1152/jn.00906.2010.
Birdno MJ, Kuncel AM, Dorval AD, Turner DA, Gross RE, Grill WM. Stimulus features underlying reduced tremor suppression with temporally patterned deep brain stimulation. J Neurophysiol. 2012 Jan;107(1):364–383.

Published In

J Neurophysiol

DOI

EISSN

1522-1598

Publication Date

January 2012

Volume

107

Issue

1

Start / End Page

364 / 383

Location

United States

Related Subject Headings

  • Tremor
  • Thalamus
  • Neurology & Neurosurgery
  • Neural Pathways
  • Neural Inhibition
  • Nerve Net
  • Motor Cortex
  • Models, Neurological
  • Middle Aged
  • Male