Dayal, V;
De Roquemaurel, A;
Grover, T;
Ferreira, F;
Salazar, M;
Milabo, C;
Candelario‐McKeown, J;
... Foltynie, T; + view all
(2020)
Novel Programming Features Help Alleviate Subthalamic Nucleus Stimulation‐Induced Side Effects.
Movement Disorders
10.1002/mds.28252.
(In press).
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Abstract
Background: Subthalamic nucleus deep brain stimulation (STN‐DBS) is a widely used treatment for Parkinsonʼs disease (PD) patients with motor complications, but can result in adverse effects (AEs) in a significant proportion of treated patients. The use of novel programming features including short pulse width (PW) and directional steering in alleviating stimulation‐induced AEs has not been explored. / Objective: To determine if programming with short PW, directional steering, or the combination of these novel techniques can improve stimulation‐induced dysarthria, dyskinesia, and pyramidal AEs. / Methods: Thirty‐two consecutive PD patients who experienced reversible AEs of STN‐DBS had optimization of their settings using either short PW, directional steering, or the combination, while ensuring equivalent control of motor symptoms. Pairwise comparisons of pre‐ and post‐optimization adverse effect ratings were made. Patients were left on the alternative setting with the greatest benefit and followed up at 6 months. Modeling of volume of tissue activated (VTA) and charge per pulse (Qp) calculations were used to explore potential underlying mechanisms of any differences found. / Results: There were significant improvements in stimulation‐induced dysarthria, dyskinesia, and pyramidal side effects after optimization. At 6 months, mean AE ratings remained significantly improved compared to pre‐optimization ratings. Different patterns of shift in VTA for each AE, and Qp could be used to explain improvements using novel techniques. / Conclusions: Stimulation‐induced dysarthria, dyskinesia, and pyramidal AEs induced by STN‐DBS can be improved by using novel programming techniques. These represent additional tools to conventional methods that can be used to address these AEs.
| Type: | Article |
|---|---|
| Title: | Novel Programming Features Help Alleviate Subthalamic Nucleus Stimulation‐Induced Side Effects |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1002/mds.28252 |
| Publisher version: | https://doi.org/10.1002/mds.28252 |
| Language: | English |
| Additional information: | Copyright © 2020 The Authors. Movement Disorders published by Wiley Periodicals LLC. on behalf of International Parkinson and Movement Disorder Society. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
| Keywords: | deep brain stimulation, Parkinsonʼs disease, subthalamic nucleus, directional, pulse width, side effects |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Movement Neurosciences UCL > Provost and Vice Provost Offices > UCL BEAMS UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Med Phys and Biomedical Eng |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10111065 |
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