Lower stimulation frequency can enhance tolerability and efficacy of pallidal deep brain stimulation for dystonia.
Identifieur interne : 001A11 ( Ncbi/Merge ); précédent : 001A10; suivant : 001A12Lower stimulation frequency can enhance tolerability and efficacy of pallidal deep brain stimulation for dystonia.
Auteurs : Ron L. Alterman [États-Unis] ; Jay L. Shils ; Joan Miravite ; Michele TagliatiSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2007.
English descriptors
- KwdEn :
- MESH :
- adverse effects : Deep Brain Stimulation.
- methods : Deep Brain Stimulation.
- pathology : Dystonia.
- radiation effects : Globus Pallidus.
- Dose-Response Relationship, Radiation, Follow-Up Studies, Humans, Magnetic Resonance Imaging, Male, Middle Aged.
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.
DOI: 10.1002/mds.21274
PubMed: 17216642
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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.</div></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">17216642</PMID><DateCreated><Year>2007</Year><Month>03</Month><Day>06</Day></DateCreated><DateCompleted><Year>2007</Year><Month>05</Month><Day>01</Day></DateCompleted><Article PubModel="Print"><Journal><ISSN IssnType="Print">0885-3185</ISSN><JournalIssue CitedMedium="Print"><Volume>22</Volume><Issue>3</Issue><PubDate><Year>2007</Year><Month>Feb</Month><Day>15</Day></PubDate></JournalIssue><Title>Movement disorders : official journal of the Movement Disorder Society</Title><ISOAbbreviation>Mov. Disord.</ISOAbbreviation></Journal><ArticleTitle>Lower stimulation frequency can enhance tolerability and efficacy of pallidal deep brain stimulation for dystonia.</ArticleTitle><Pagination><MedlinePgn>366-8</MedlinePgn></Pagination><Abstract><AbstractText>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. 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Shils</name><name sortKey="Tagliati, Michele" sort="Tagliati, Michele" uniqKey="Tagliati M" first="Michele" last="Tagliati">Michele Tagliati</name></noCountry><country name="États-Unis"><noRegion><name sortKey="Alterman, Ron L" sort="Alterman, Ron L" uniqKey="Alterman R" first="Ron L" last="Alterman">Ron L. Alterman</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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