Objective: To compare 4 weeks of STN-DBS with conventional pulse width stimulation (60µs) to 4 weeks of STN-DBS with short pulse width stimulation (30µs) regarding motor symptom control.

Background: Subthalamic nucleus deep brain stimulation (STN-DBS) is a well-established treatment for patients with Parkinson’s Disease. Previous acute challenge studies suggested that short pulse widths might increase the therapeutic window while maintaining motor symptom control with a decrease in energy consumption. However, only little is known about the effect of short pulse width stimulation beyond the setting of an acute challenge.

Method: This study was a monocentric, double-blinded, randomized crossover noninferiority trial investigating whether short pulse width stimulation with 30µs maintains equal motor control as conventional 60µs stimulation over a period of 4 weeks (German Clinical Trials Register No. DRKS00017528). Primary outcome was the difference in motor symptom control as assessed by a motor diary. Secondary outcomes included energy consumption measures, non-motor effects, side-effects, and quality of life.

Results: Due to a high dropout rate, the calculated sample size of 27 patients was not met and 24 patients with Parkinson ’s Disease and STN-DBS were included in the final analysis. However, there were no differences in any investigated outcome parameter between the two treatment conditions.

Conclusion: This study demonstrates that short pulse width settings (30µs) provide non-inferior motor symptom control as conventional (60µs) stimulation without significant differences in energy consumption. Future studies are warranted to evaluate a potential benefit of short pulse width settings in patients with pronounced dyskinesia.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/a-randomized-double-blinded-crossover-trial-of-short-versus-conventional-pulse-width-subthalamic-deep-brain-stimulation-in-parkinsons-disease/