Pulse duration settings in subthalamic stimulation for Parkinson's disease.

ABSTRACT: BACKGROUND:Stimulation parameters in deep brain stimulation (DBS) of the subthalamic nucleus for Parkinson's disease (PD) are rarely tested in double-blind conditions. Evidence-based recommendations on optimal stimulator settings are needed. Results from the CUSTOM-DBS study are reported, comparing 2 pulse durations. METHODS:A total of 15 patients were programmed using a pulse width of 30?µs (test) or 60?µs (control). Efficacy and side-effect thresholds and unified PD rating scale (UPDRS) III were measured in meds-off (primary outcome). The therapeutic window was the difference between patients' efficacy and side effect thresholds. RESULTS:The therapeutic window was significantly larger at 30?µs than 60?µs (P?=?·0009) and the efficacy (UPDRS III score) was noninferior (P?=?.00008). INTERPRETATION:Subthalamic neurostimulation at 30?µs versus 60?µs pulse width is equally effective on PD motor signs, is more energy efficient, and has less likelihood of stimulation-related side effects. © 2017 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

SUBMITTER: Steigerwald F 

PROVIDER: S-EPMC5813170 | biostudies-literature | 2018 Jan

REPOSITORIES: biostudies-literature