Universität zu Köln

Steffen, Julia K., Reker, Paul ORCID: 0000-0003-4590-708X, Mennicken, Fiona K., Dembek, Till A., Dafsari, Haidar S., Fink, Gereon R. ORCID: 0000-0002-8230-1856, Visser-Vandewalle, Veerle and Barbe, Michael T. (2020). Bipolar Directional Deep Brain Stimulation in Essential and Parkinsonian Tremor. Neuromodulation, 23 (4). S. 543 - 550. HOBOKEN: WILEY. ISSN 1525-1403

Full text not available from this repository.

Abstract

Objective To compare directional monopolar, bipolar, and directional bipolar thalamic deep brain stimulation (DBS) in tremor patients. Methods Fourteen tremor patients (7 Essential Tremor and 7 Parkinson's Disease) implanted with directional DBS electrodes in the ventral intermediate nucleus (VIM) were enrolled. Side-effect thresholds of monopolar directional stimulation (DIRECT) were compared to circular DBS as well as, in a randomized design, to those of two different bipolar stimulation settings (BIPOLAR = circular anode; BI-DIRECT = directional anode). Tremor suppression (Tremor Rating Scale, TRS) right below the side-effect threshold was also assessed. Results Directional DBS in the individually best direction showed higher side-effect thresholds than circular DBS (p= 0.0063). The thresholds were raised further using either one of the bipolar stimulation paradigms (BIPOLARp= 0.0029, BI-DIRECTp= 0.0022). The side-effect thresholds did not differ between both bipolar settings, but side-effects were less frequent with BI-DIRECT. No difference in TRS scores with stimulation just below the side-effect threshold was found between all stimulation conditions. Conclusions Side-effect thresholds of monopolar directional and bipolar stimulation with both circular and directional anodes were higher compared to traditional monopolar circular stimulation in the VIM. Bipolar DBS with directional anodes evoked side-effect less frequently than bipolar and monopolar directional stimulation. All stimulation settings had comparable effects on tremor suppression just below their side-effect thresholds. Thus, directional and different bipolar settings should be explored in patients with bothersome side-effects of thalamic stimulation when monopolar stimulation settings are not satisfying. Further studies are needed to explore the efficiency of the different bipolar stimulation paradigms.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Steffen, Julia K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Reker, Paul UNSPECIFIED orcid.org/0000-0003-4590-708X UNSPECIFIED Mennicken, Fiona K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Dembek, Till A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Dafsari, Haidar S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fink, Gereon R. UNSPECIFIED orcid.org/0000-0002-8230-1856 UNSPECIFIED Visser-Vandewalle, Veerle UNSPECIFIED UNSPECIFIED UNSPECIFIED Barbe, Michael T. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-331808
DOI:	10.1111/ner.13109
Journal or Publication Title:	Neuromodulation
Volume:	23
Number:	4
Page Range:	S. 543 - 550
Date:	2020
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1525-1403
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language Medicine, Research & Experimental; Clinical Neurology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/33180