BACKGROUND: Dystonia often has inconsistent benefits and requires more energy-demanding DBS settings. Studies suggest that squared biphasic pulses could provide significant clinical benefit; however, dystonia patients have not been explored. OBJECTIVES: To assess safety and tolerability of square biphasic DBS in dystonia patients. METHODS: This study included primary generalized or cervical dystonia patients with bilateral GPi DBS. Square biphasic pulses were implemented and patients were assessed at baseline, immediately postwashout, post-30-minute washout, 1 hour post- and 2 hours postinitiation of investigational settings. RESULTS: Ten participants completed the study. There were no patient-reported or clinician-observed side effects. There was improvement across time on the Toronto Western Spasmodic Torticollis Rating Scale (χ2 = 10.7; P = 0.031). Similar improvement was detected in objective gait measurements. CONCLUSIONS: Square biphasic stimulation appears safe and feasible in dystonia patients with GPi DBS. Further studies are needed to evaluate possible effectiveness particularly in cervical and gait features.
BACKGROUND:Dystonia often has inconsistent benefits and requires more energy-demanding DBS settings. Studies suggest that squared biphasic pulses could provide significant clinical benefit; however, dystoniapatients have not been explored. OBJECTIVES: To assess safety and tolerability of square biphasic DBS in dystoniapatients. METHODS: This study included primary generalized or cervical dystoniapatients with bilateral GPi DBS. Square biphasic pulses were implemented and patients were assessed at baseline, immediately postwashout, post-30-minute washout, 1 hour post- and 2 hours postinitiation of investigational settings. RESULTS: Ten participants completed the study. There were no patient-reported or clinician-observed side effects. There was improvement across time on the Toronto Western Spasmodic Torticollis Rating Scale (χ2 = 10.7; P = 0.031). Similar improvement was detected in objective gait measurements. CONCLUSIONS: Square biphasic stimulation appears safe and feasible in dystoniapatients with GPi DBS. Further studies are needed to evaluate possible effectiveness particularly in cervical and gait features.
Authors: Sol De Jesus; Michael S Okun; Kelly D Foote; Daniel Martinez-Ramirez; Jaimie A Roper; Chris J Hass; Leili Shahgholi; Umer Akbar; Aparna Wagle Shukla; Robert S Raike; Leonardo Almeida Journal: Front Hum Neurosci Date: 2019-10-17 Impact factor: 3.169
Authors: Adolfo Ramirez-Zamora; James J Giordano; Aysegul Gunduz; Peter Brown; Justin C Sanchez; Kelly D Foote; Leonardo Almeida; Philip A Starr; Helen M Bronte-Stewart; Wei Hu; Cameron McIntyre; Wayne Goodman; Doe Kumsa; Warren M Grill; Harrison C Walker; Matthew D Johnson; Jerrold L Vitek; David Greene; Daniel S Rizzuto; Dong Song; Theodore W Berger; Robert E Hampson; Sam A Deadwyler; Leigh R Hochberg; Nicholas D Schiff; Paul Stypulkowski; Greg Worrell; Vineet Tiruvadi; Helen S Mayberg; Joohi Jimenez-Shahed; Pranav Nanda; Sameer A Sheth; Robert E Gross; Scott F Lempka; Luming Li; Wissam Deeb; Michael S Okun Journal: Front Neurosci Date: 2018-01-24 Impact factor: 4.677