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Deep Brain Stimulation with Simultaneous fMRI in Rodents
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Deep brain stimulation parameters for dystonia: A systematic review.

Philippe Magown1, Rafael A Andrade2, Alexandra Soroceanu3

  • 1University of Calgary, Clinical Neurosciences (Neurosurgery), Calgary, Alberta, Canada.

Parkinsonism & Related Disorders
|April 30, 2018
PubMed
Summary

Deep brain stimulation (DBS) programming for dystonia is complex. This review found consistency in amplitude and frequency, but variability in pulse widths, highlighting the need for standardized reporting and further research in DBS for dystonia.

Keywords:
Deep brain stimulationDystoniaElectrical parametersSystematic review

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Area of Science:

  • Neurology
  • Neurosurgery
  • Biomedical Engineering

Background:

  • Programming deep brain stimulation (DBS) for dystonia is challenging due to gradual clinical benefits and programming variability.
  • Discrepancies exist in recommended starting DBS parameters, complicating outcome comparisons and generator programming.
  • This variability is observed across different dystonia subtypes, further increasing programming complexity.

Purpose of the Study:

  • To systematically review and quantify the variability of globus pallidus pars interna (GPi) deep brain stimulation (DBS) parameters used in dystonia treatment.
  • To identify common stimulation parameters and assess consistency across reported GPi DBS settings for dystonia.

Main Methods:

  • A comprehensive systematic literature search was conducted across PubMed/Medline, Embase, and Cochrane databases for GPi DBS stimulation parameters in dystonia.
  • Data were extracted from 192 publications, encompassing 1505 patients and 2964 electrodes.
  • Extracted data included stimulation amplitude, frequency, and pulse width.

Main Results:

  • The review analyzed data from 192 publications representing 1505 patients and 2964 electrodes.
  • Average stimulation amplitude was 3.3 ± 0.6 V and average frequency was 131 ± 5 Hz.
  • Three common pulse widths were identified: 112 ± 31 μs, 203 ± 22 μs, and 446 ± 8 μs.

Conclusions:

  • Despite anecdotal variations, GPi DBS for dystonia shows consistency in utilized amplitude and frequency.
  • Specific pulse widths may be beneficial for certain dystonia subtypes.
  • The study emphasizes the need for comprehensive data reporting and suggests large-scale, controlled studies and international registries to optimize DBS settings for dystonia.