Objective: To explore interleaving versus conventional stimulation in subthlalmic nucleus (STN) deep brain stimulation (DBS) in optimizing the effect.

Background: STN DBS is effective for motor complication or symptoms in Parkinson’s disease (PD). Due to the complex functional anatomy of the target, the effect of conventional stimulation (monopolar and bipolar stimulation) can be limited by simulation-induced side effects, including dyskinesia and imbalance. We report a case with better effect comparing interleaving and conventional stimulation for optimizing the effect of STN DBS for PD.

Methods: A 59 -year old gentlemen with PD for 8 years suffered from motor –complication for 2 years. Before DBS, he had 40% “OFF” period in awake- time which affected his daily living i.e. driving, using computer and work. He received bilateral STN DBS in 2016. His” Off “symptoms could be reduced to 20% using monopolar stimulation at voltage 1.3, Pulse Width 60uS, Rate 130Hz. However, the stimulation caused right leg lateral swing during walking. When changed to bipolar setting to achieve the similar effect for his OFF symptoms, he developed hand clumsiness, which affected his computer work and driving. Finally, the left STN stimulation changed to switching between low voltage monopolar & high voltage bipolar interleaving stimulation. He enjoyed the same effect for his OFF symptoms without the side effects.

Results:

Conclusions: In selective case of STN DBS for PD, interleaving stimulation is useful for maximizing symptom control while minimizing side effects.

« Back to 2018 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/optimizing-the-subthalamic-nucleus-stn-deep-brain-stimulation-dbs-outcome-in-parkinsons-disease-patient-with-interleaving-stimulation/