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Author Notes:

Warren M. Grill, Department of Biomedical Engineering, Duke University, Box 90281, Durham NC 27708-0281, USA. Fax: + 1 919 684 4488. warren.grill@duke.edu.

D.T.B. and W.M.G. are inventors on patent applications related to non-regular patterns of DBS and hold equity in Deep Brain Innovations, LLC, which has licensed intellectual property from Duke University.

Subjects:

Research Funding:

This research was supported by National Institutes of Health [R01 NS40894 to W.M.G.]; and the Robert Plonsey Fellowship from the Duke University Department of Biomedical Engineering [to D.T.B.].

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Neurosciences
  • Neurosciences & Neurology
  • Parkinson's disease
  • Deep brain stimulation
  • Bradykinesia
  • Beta frequency oscillations
  • SUBTHALAMIC NUCLEUS STIMULATION
  • HIGH-FREQUENCY STIMULATION
  • NEURONAL-ACTIVITY
  • BASAL GANGLIA
  • PALLIDAL STIMULATION
  • STIMULUS PARAMETERS
  • BRADYKINESIA
  • TREMOR
  • MODEL
  • PATHOPHYSIOLOGY

Improved Efficacy of Temporally Non-Regular Deep Brain Stimulation in Parkinson's Disease

Tools:

Journal Title:

Experimental Neurology

Volume:

Volume 239, Number 1

Publisher:

, Pages 60-67

Type of Work:

Article | Post-print: After Peer Review

Abstract:

High frequency deep brain stimulation is an effective therapy for motor symptoms in Parkinson's disease. However, the relative clinical efficacy of regular versus non-regular temporal patterns of stimulation in Parkinson's disease remains unclear. To determine the temporal characteristics of non-regular temporal patterns of stimulation important for the treatment of Parkinson's disease, we compared the efficacy of temporally regular stimulation with four non-regular patterns of stimulation in subjects with Parkinson's disease using an alternating finger tapping task. The patterns of stimulation were also evaluated in a biophysical model of the parkinsonian basal ganglia that exhibited prominent oscillatory activity in the beta frequency range. The temporal patterns of stimulation differentially improved motor task performance. Three of the non-regular patterns of stimulation improved performance of the finger tapping task more than temporally regular stimulation. In the computational model all patterns of deep brain stimulation suppressed beta band oscillatory activity, and the degree of suppression was strongly correlated with the clinical efficacy across stimulation patterns. The three non-regular patterns of stimulation that improved motor performance over regular stimulation also suppressed beta band oscillatory activity in the computational model more effectively than regular stimulation. These data demonstrate that the temporal pattern of stimulation is an important consideration for the clinical efficacy of deep brain stimulation in Parkinson's disease. Furthermore, non-regular patterns of stimulation may ameliorate motor symptoms and suppress pathological rhythmic activity in the basal ganglia more effectively than regular stimulation. Therefore, non-regular patterns of deep brain stimulation may have useful clinical and experimental applications.

Copyright information:

© 2012 Elsevier Inc. All rights reserved.

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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