Shorter pulse width reduces gait disturbances following deep brain stimulation for essential tremor.
In: Journal of neurology, neurosurgery, and psychiatry, Jg. 90 (2019-09-01), Heft 9, S. 1046-1050
academicJournal
Zugriff:
Objective: Gait disturbances are frequent side effects occurring during chronic thalamic deep brain stimulation (DBS) in patients with essential tremor (ET). Adapting stimulation settings to shorter pulse widths has been shown to reduce side effects of subthalamic DBS. Here, we assess how a reduction of pulse width changes gait performance of affected patients.
Methods: Sensor-based gait assessment was performed to record spatiotemporal gait parameters in 10 healthy subjects (HS) and 7 patients with ET with gait disturbances following thalamic DBS. Patients were tested during standard DBS, after 72 hours of stimulation withdrawal and at least 30 days after adjusting DBS settings to a shorter pulse width of 40 µs (DBS40PW).
Results: Patients with ET on standard DBS showed significantly higher variability of several spatiotemporal gait parameters compared with HS. Variability of stride length and range of motion of the shanks significantly decreased OFF DBS as compared with standard DBS. This improvement was maintained over 30 days with DBS40PW while providing effective tremor suppression in six out of seven patients.
Conclusion: Shorter pulse widths may reduce gait disturbances in patients with ET that are induced by DBS while preserving a level of tremor suppression equal to standard stimulation settings.
Competing Interests: Competing interests: DK, SE and A-CM declare no competing interests or financial dependencies. AK received honoraria from Medtronic, Boston Scientific and St Jude Medical, is member of an advisory board for Boston Scientific, received a travel grant from Boston Scientific, and received a research grant from Medtronic.
(© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
| Titel: |
Shorter pulse width reduces gait disturbances following deep brain stimulation for essential tremor.
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| Autor/in / Beteiligte Person: | Kroneberg, D ; Ewert, S ; Meyer, AC ; Kühn, AA |
| Zeitschrift: | Journal of neurology, neurosurgery, and psychiatry, Jg. 90 (2019-09-01), Heft 9, S. 1046-1050 |
| Veröffentlichung: | London : BMJ Publishing Group ; <i>Original Publication</i>: London : British Medical Association, 2019 |
| Medientyp: | academicJournal |
| ISSN: | 1468-330X (electronic) |
| DOI: | 10.1136/jnnp-2018-319427 |
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