Session Information
Date: Monday, June 20, 2016
Session Title: Surgical therapy: Parkinson's disease
Session Time: 12:30pm-2:00pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To evaluate (1) clinical usefulness and (2) adverse effects of thirty microseconds pulse width stimulation in deep brain stimulation of the globus pallidus internus (GPi-DBS).
Background: GPi-DBS is an established surgical treatment for dyskinesia in advanced Parkinson’s disease (PD). Compared to subthalamic stimulation(STN-DBS), psychiatric complication is small, and improvemnt in motor score is same in GPi-DBS. The outcome depends on electrode location and stimulation settings. Though high current stimulation is needed in some situation, that condition may affects into fiber tracts, such as pyramidal fibers. In this study, we surveyed the clinical usefulness and adverse effects of 30 microseconds pulse width stimulation.
Methods: Six PD patients, twelve electrodes who had been implanted with Boston Vercise system for bilateral GPi-DBS. We underwent programming sessions in medication off-state, one week after operation. The motor symptoms and adverse effects were evaluated.
Results: Mean UPDRS-III motor score improvement from 51.0+/-12.5 before surgery to 25.4+/-9.5 points in the medication off-state with GPi-DBS. The therapeutic window in 30 microsec. pulse width stimulation was 2.25 to 5.65 mA. That of 60 microsec. was 2.52 to 7.44 mA. The motor score difference in 3.0mA stim between 30 microsec. pulse width stimulation versus 60 microsec. stim. was 3.2 in UPDRS-III. Four patients selected 30 microsec. pulse width stimulation, because they feel more comfortable than 60 despite no difference of motor score.
Conclusions: This is the first report for 30 microsec. pulse width stimulation for GPi-DBS in PD. The stimulation with 30 microsec. pulse width in GPi-DBS was usuful. The therapeutic window was wider in 30 microsec. pulse width stim. than 60 microsec. The improvement of motor score was almost same. The tolerability of stimlation in 30 microsec. pulse width stim. was higher than 60 microsec. Our data suggest that 30 microsec. stim was useful for GPi-DBS with avoiding adverse effects. A limitation may be the small number of patients investigated. A future clinical study including blinded assessments of stimulation needs to ascertain this concept.
To cite this abstract in AMA style:
K. Kimura, H. Kishida, N. Ueda, K. Hamada, T. Kawasaki, F. Tanaka. The effect of short pulse width neurostimulation in GPi-DBS [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/the-effect-of-short-pulse-width-neurostimulation-in-gpi-dbs/. Accessed November 22, 2024.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/the-effect-of-short-pulse-width-neurostimulation-in-gpi-dbs/