Short pulse and directional thalamic deep brain stimulation have differential effects in parkinsonian and essential tremor
Abstract The aim of this study was to assess the effects of novel stimulation algorithms of deep brain stimulation (short pulse and directional stimulation) in the ventrointermediate thalamus and posterior subthalamic area (VIM/PSA-DBS) on tremor in Parkinson’s disease (PD) and to compare the effect...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2022-05-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-11291-9 |
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| author | Ute Hidding Miriam Schaper Alessandro Gulberti Carsten Buhmann Christian Gerloff Christian K. E. Moll Wolfgang Hamel Chi-un Choe Monika Pötter-Nerger |
| author_facet | Ute Hidding Miriam Schaper Alessandro Gulberti Carsten Buhmann Christian Gerloff Christian K. E. Moll Wolfgang Hamel Chi-un Choe Monika Pötter-Nerger |
| author_sort | Ute Hidding |
| collection | DOAJ |
| description | Abstract The aim of this study was to assess the effects of novel stimulation algorithms of deep brain stimulation (short pulse and directional stimulation) in the ventrointermediate thalamus and posterior subthalamic area (VIM/PSA-DBS) on tremor in Parkinson’s disease (PD) and to compare the effects with those in essential tremor (ET). We recruited six PD patients (70.8 ± 10.4 years) and seven ET patients (64.4 ± 9.9 years) with implanted VIM/PSA-DBS in a stable treatment condition (> 3 months postoperatively). Tremor severity and ataxia were assessed in four different stimulation conditions in a randomized order: DBS switched off (STIM OFF), omnidirectional stimulation with 60 µs (oDBS60), omnidirectional stimulation with 30 µs (oDBS30), directional stimulation at the best segment with 60 µs (dDBS60). In both patient groups, all three DBS stimulation modes reduced the total tremor score compared to STIM OFF, whereas stimulation-induced ataxia was reduced by oDBS30 and partially by dDBS60 compared to oDBS60. Tremor reduction was more pronounced in PD than in ET due to a limited DBS effect on intention and action-specific drawing tremor in ET. In PD and ET tremor, short pulse or directional VIM/PSA-DBS is an effective and well tolerated therapeutic option. Trial registration: The study was registered in the DRKS (ID DRKS00025329, 18.05.2021, German Clinical Trials Register, DRKS—Deutsches Register Klinischer Studien). |
| first_indexed | 2024-12-12T15:56:44Z |
| format | Article |
| id | doaj.art-111cf701ddb44e7ba8d6dc40d69e4acf |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-12T15:56:44Z |
| publishDate | 2022-05-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-111cf701ddb44e7ba8d6dc40d69e4acf2022-12-22T00:19:29ZengNature PortfolioScientific Reports2045-23222022-05-0112111210.1038/s41598-022-11291-9Short pulse and directional thalamic deep brain stimulation have differential effects in parkinsonian and essential tremorUte Hidding0Miriam Schaper1Alessandro Gulberti2Carsten Buhmann3Christian Gerloff4Christian K. E. Moll5Wolfgang Hamel6Chi-un Choe7Monika Pötter-Nerger8Department of Neurology, University Medical Center Hamburg-EppendorfDepartment of Neurosurgery, University Medical Center Hamburg-EppendorfDepartment of Neurology, University Medical Center Hamburg-EppendorfDepartment of Neurology, University Medical Center Hamburg-EppendorfDepartment of Neurology, University Medical Center Hamburg-EppendorfDepartment of Neurophysiology and Pathophysiology, University Medical Center Hamburg-EppendorfDepartment of Neurosurgery, University Medical Center Hamburg-EppendorfDepartment of Neurology, University Medical Center Hamburg-EppendorfDepartment of Neurology, University Medical Center Hamburg-EppendorfAbstract The aim of this study was to assess the effects of novel stimulation algorithms of deep brain stimulation (short pulse and directional stimulation) in the ventrointermediate thalamus and posterior subthalamic area (VIM/PSA-DBS) on tremor in Parkinson’s disease (PD) and to compare the effects with those in essential tremor (ET). We recruited six PD patients (70.8 ± 10.4 years) and seven ET patients (64.4 ± 9.9 years) with implanted VIM/PSA-DBS in a stable treatment condition (> 3 months postoperatively). Tremor severity and ataxia were assessed in four different stimulation conditions in a randomized order: DBS switched off (STIM OFF), omnidirectional stimulation with 60 µs (oDBS60), omnidirectional stimulation with 30 µs (oDBS30), directional stimulation at the best segment with 60 µs (dDBS60). In both patient groups, all three DBS stimulation modes reduced the total tremor score compared to STIM OFF, whereas stimulation-induced ataxia was reduced by oDBS30 and partially by dDBS60 compared to oDBS60. Tremor reduction was more pronounced in PD than in ET due to a limited DBS effect on intention and action-specific drawing tremor in ET. In PD and ET tremor, short pulse or directional VIM/PSA-DBS is an effective and well tolerated therapeutic option. Trial registration: The study was registered in the DRKS (ID DRKS00025329, 18.05.2021, German Clinical Trials Register, DRKS—Deutsches Register Klinischer Studien).https://doi.org/10.1038/s41598-022-11291-9 |
| spellingShingle | Ute Hidding Miriam Schaper Alessandro Gulberti Carsten Buhmann Christian Gerloff Christian K. E. Moll Wolfgang Hamel Chi-un Choe Monika Pötter-Nerger Short pulse and directional thalamic deep brain stimulation have differential effects in parkinsonian and essential tremor Scientific Reports |
| title | Short pulse and directional thalamic deep brain stimulation have differential effects in parkinsonian and essential tremor |
| title_full | Short pulse and directional thalamic deep brain stimulation have differential effects in parkinsonian and essential tremor |
| title_fullStr | Short pulse and directional thalamic deep brain stimulation have differential effects in parkinsonian and essential tremor |
| title_full_unstemmed | Short pulse and directional thalamic deep brain stimulation have differential effects in parkinsonian and essential tremor |
| title_short | Short pulse and directional thalamic deep brain stimulation have differential effects in parkinsonian and essential tremor |
| title_sort | short pulse and directional thalamic deep brain stimulation have differential effects in parkinsonian and essential tremor |
| url | https://doi.org/10.1038/s41598-022-11291-9 |
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