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Author Notes:

Corresponding Author: W.M. Grill, Duke University, Department of Biomedical Engineering, Hudson Hall, Rm 136, Box 90281, Durham NC 27708-0281, USA, Tel.: +1 919 660 5276, Fax: +1 919 684 4488, Email:warren.grill@duke.edu

W.M.G. is an inventor on patent applications related to non-regular patterns of DBS and holds equity in Deep Brain Innovations, LLC, which has licensed intellectual property from Duke University.

The terms of this arrangement have been reviewed and approved by Duke University in accordance with its conflict of interest policies.


Research Funding:

This research was supported by the National Institutes of Health (R01 NS40894).

R.E.G. receives research funding from Medtronic; he also serves as a consultant to Medtronic and receives compensation for these services.

The terms of this arrangement have been reviewed and approved by Emory University in accordance with its conflict of interest policies.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Clinical Neurology
  • Neurosciences
  • Neurosciences & Neurology
  • Essential tremor
  • Movement disorders
  • Thalamus
  • Deep brain stimulation
  • Computational model

Short pauses in thalamic deep brain stimulation promote tremor and neuronal bursting


Journal Title:

Clinical Neurophysiology


Volume 127, Number 2


, Pages 1551-1559

Type of Work:

Article | Post-print: After Peer Review


Objective: We conducted intraoperative measurements of tremor during DBS containing short pauses (≤50. ms) to determine if there is a minimum pause duration that preserves tremor suppression. Methods: Nine subjects with ET and thalamic DBS participated during IPG replacement surgery. Patterns of DBS included regular 130. Hz stimulation interrupted by 0, 15, 25 or 50. ms pauses. The same patterns were applied to a model of the thalamic network to quantify effects of pauses on activity of model neurons. Results: All patterns of DBS decreased tremor relative to 'off'. Patterns with pauses generated less tremor reduction than regular high frequency DBS. The model revealed that rhythmic burst-driver inputs to thalamus were masked during DBS, but pauses in stimulation allowed propagation of bursting activity. The mean firing rate of bursting-type model neurons as well as the firing pattern entropy of model neurons were both strongly correlated with tremor power across stimulation conditions. Conclusions: The temporal pattern of stimulation influences the efficacy of thalamic DBS. Pauses in stimulation resulted in decreased tremor suppression indicating that masking of pathological bursting is a mechanism of thalamic DBS for tremor. Significance: Pauses in stimulation decreased the efficacy of open-loop DBS for suppression of tremor.

Copyright information:

© 2015 International Federation of Clinical Neurophysiology.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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