Lower stimulation frequency can enhance tolerability and efficacy of pallidal deep brain stimulation for dystonia
Identifieur interne : 003137 ( Istex/Corpus ); précédent : 003136; suivant : 003138Lower stimulation frequency can enhance tolerability and efficacy of pallidal deep brain stimulation for dystonia
Auteurs : Ron L. Alterman ; Jay L. Shils ; Joan Miravite ; Michele TagliatiSource :
- Movement Disorders [ 0885-3185 ] ; 2007-02-15.
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Abstract
We report the case of a patient with medically refractory primary dystonia who was treated with bilateral pallidal deep brain stimulation. Stimulation at 130 Hz or higher, by means of the more ventral contacts generated capsular side effects, which made their use impractical. Consequently, the patient was treated for 9 months at 130 to 185 Hz, by means of the more dorsal contacts, achieving modest results. By reducing the stimulation frequency to 80 Hz, we were able to activate the ventral contacts without inducing side effects. Within days, the patient experienced a dramatic improvement in function that has persisted for 1 year. A further reduction in stimulation frequency to 60 Hz resulted in a worsening of his symptoms. We conclude that chronic stimulation at frequencies of <100 Hz may be efficacious in dystonia and may enhance the tolerability of stimulation by means of contacts that are positioned posteroventrally within the internal globus pallidus, nearer the internal capsule. © 2006 Movement Disorder Society
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DOI: 10.1002/mds.21274
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Stimulation at 130 Hz or higher, by means of the more ventral contacts generated capsular side effects, which made their use impractical. Consequently, the patient was treated for 9 months at 130 to 185 Hz, by means of the more dorsal contacts, achieving modest results. By reducing the stimulation frequency to 80 Hz, we were able to activate the ventral contacts without inducing side effects. Within days, the patient experienced a dramatic improvement in function that has persisted for 1 year. A further reduction in stimulation frequency to 60 Hz resulted in a worsening of his symptoms. We conclude that chronic stimulation at frequencies of <100 Hz may be efficacious in dystonia and may enhance the tolerability of stimulation by means of contacts that are positioned posteroventrally within the internal globus pallidus, nearer the internal capsule. © 2006 Movement Disorder Society</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><!--Version 0.6 générée le 3-12-2015--><mods version="3.6"><titleInfo lang="en"><title>Lower stimulation frequency can enhance tolerability and efficacy of pallidal deep brain stimulation for dystonia</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Pallidal DBS for Dystonia</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Lower stimulation frequency can enhance tolerability and efficacy of pallidal deep brain stimulation for dystonia</title></titleInfo><name type="personal"><namePart type="given">Ron L.</namePart><namePart type="family">Alterman</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Mount Sinai School of Medicine, New York, New York, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jay L.</namePart><namePart type="family">Shils</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Lahey Clinic, Burlington, Massachusetts, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Joan</namePart><namePart type="family">Miravite</namePart><namePart type="termsOfAddress">FNP</namePart><affiliation>Mount Sinai School of Medicine, New York, New York, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Michele</namePart><namePart type="family">Tagliati</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Mount Sinai School of Medicine, New York, New York, USA</affiliation><description>Correspondence: Department of Neurology, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1139, New York, NY 10029</description><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre authority="originalCategForm">article</genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2007-02-15</dateIssued><dateCaptured encoding="w3cdtf">2006-01-15</dateCaptured><dateValid encoding="w3cdtf">2006-08-31</dateValid><copyrightDate encoding="w3cdtf">2007</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">1</extent><extent unit="tables">1</extent><extent unit="references">11</extent><extent unit="words">2078</extent></physicalDescription><abstract lang="en">We report the case of a patient with medically refractory primary dystonia who was treated with bilateral pallidal deep brain stimulation. Stimulation at 130 Hz or higher, by means of the more ventral contacts generated capsular side effects, which made their use impractical. Consequently, the patient was treated for 9 months at 130 to 185 Hz, by means of the more dorsal contacts, achieving modest results. By reducing the stimulation frequency to 80 Hz, we were able to activate the ventral contacts without inducing side effects. Within days, the patient experienced a dramatic improvement in function that has persisted for 1 year. A further reduction in stimulation frequency to 60 Hz resulted in a worsening of his symptoms. We conclude that chronic stimulation at frequencies of <100 Hz may be efficacious in dystonia and may enhance the tolerability of stimulation by means of contacts that are positioned posteroventrally within the internal globus pallidus, nearer the internal capsule. © 2006 Movement Disorder Society</abstract><note type="funding">The Bachmann–Strauss Dystonia and Parkinson Foundation</note><subject lang="en"><genre>Keywords</genre><topic>dystonia</topic><topic>deep brain stimulation</topic><topic>frequency</topic><topic>globus pallidus</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title><subTitle>Official Journal of the Movement Disorder Society</subTitle></titleInfo><titleInfo type="abbreviated"><title>Mov. 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