Deep brain stimulation parameters for dystonia: A systematic review

Pulse Width and Implantable Pulse Generator Longevity in Pallidal Deep Brain Stimulation for Dystonia: A Population-Based Comparative Effectiveness Study

“…In STN DBS for PD, PWs between 10 and 50 µs were demonstrated to increase the therapeutic window while retaining or decreasing energy consumption [36,37]. To the best of our knowledge, the effects of PWs in the 10-to 50-µs range are yet largely unexplored in GPi DBS for dystonia [9,11].…”

“…Clinical outcome was evaluated using the CGI scale [19], based on retrospective chart reviews. Although this gives a broad reflection of symptom severity, future studies should include prospectively gathered data using specific clinical evaluation methods [9,11]. Adjustments of stimulation parameters prior to or after the 1-year follow-up and electrode impedances were not recorded, complicating analysis of PEV-adjusted calculations of IPG longevity.…”

“…In GPi DBS for Parkinson's disease (PD), short (60-90 µs) and medium (120-150 µs) PWs have been used successfully [6][7][8]. Similar PWs are used by many centers for GPi DBS for dystonia, and for other movement disorders and brain targets [9]. However, other centers have chosen to use long (450 µs) PWs, following the example early advocated by researchers from Montpellier [10].…”

“…However, other centers have chosen to use long (450 µs) PWs, following the example early advocated by researchers from Montpellier [10]. Improvement of clinical outcomes for some subtypes of dystonia by the use of specific PWs has been suggested, but distinct superiority of any range of PWs has not been demonstrated [9,11]. The span of PWs used in DBS for dystonia is relatively wide and this parameter is therefore of particular interest in this context.…”

Brain stimulation methods for pain treatment

“…The method was initially developed for and applied to movement disorders in several target areas; such as the thalamus, the pallidum, and the subthalamic nucleus. It is currently being extended to other indications, such as epilepsy (Chan et al 2018;Hartl et al 2018;Lobato-Polo et al 2018;Son et al 2018), dystonia (Magown et al 2018;Takeda et al 2018), tremor (Moldovan et al 2017;Camalier et al 2018), cluster headache (Chabardès et al 2016;Láinez and Guillamón 2017), chronic pain, including pain from stroke (Lempka et al 2017;Gopalakrishnan et al 2018), amputation (Pereira et al 2013;Kuffler 2018), trigeminal neuralgia (Nizard et al 2012;Yamgoue et al 2016) and multiple sclerosis (Abboud et al 2017;Oliveria et al 2017), and recently to psychiatric disorders, such as obsessive compulsive disorder (Naesström et al 2017;Winter et al 2017;Franzini et al 2018), Tourette's syndrome (Marceglia et al 2017;Martinez-Ramirez et al 2018), and depression (Kringelbach et al 2007b). The mechanism of action will likely turn out to be quite complex, involving cell-firing inhibition, neurotransmitter depletion, jamming and excitation of inhibitory pathways that lead to functional inhibition, and mimicking the effects of lesioning of the stimulated structures (Benabid 2014).…”