Neuromodulation : journal of the International Neuromodulation Society
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To compare the therapeutic window (TW) of cathodic monopolar, bipolar, anodic monopolar, and a novel "semi-bipolar" stimulation in ten Parkinson's disease patients who underwent deep brain stimulation of the subthalamic nucleus. ⋯ While awaiting further studies, our findings suggest that cathodic stimulation should be preferred in light of its reduced battery consumption, possibly followed by semi-bipolar in case of stimulation-induced side-effects.
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Deep brain stimulation (DBS) is increasingly used to treat a wide variety of neurological and psychiatric disorders. Implantable pulse generators (implantable pulse generators/batteries) for DBS were originally only available as a nonrechargeable option. However, there is now a choice between fixed-life and rechargeable batteries, with each having their own advantages and disadvantages. The extent of patient involvement in the choice of battery and the factors that matter to them have not been well studied. ⋯ The authors' institution has received educational grants from Medtronic, Abbott, and Boston Scientific companies.
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This study sought to determine whether there is a gender disparity in patients undergoing deep brain stimulation (DBS) surgery for Parkinson's disease (PD) at a single health system, and better understand the reasons for this discrepancy. ⋯ Despite similar postsurgical improvements, women were less likely to undergo DBS surgery due to their own preference, while men were more likely to be lost to follow-up. These data underscore the need for increased education and awareness of DBS so that all patients with PD who qualify for surgery can benefit from this procedure.
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Tinnitus is the conscious perception of an auditory sensation in the absence of external stimulus. Proposed theories are based on neuroplastic changes that occur due to sensory deprivation. The authors review the relevant literature on functional imaging and neuromodulation of tinnitus and describe potential targets for deep brain stimulation (DBS). ⋯ DBS shows much promise as a therapeutic option for tinnitus. Stimulation of the auditory pathway, particularly the medial geniculate body, could counteract thalamocortical dysrhythmias and reduce gamma activity implicated in the tinnitus percept. Stimulation of the limbic pathway could decrease attention to and perception of tinnitus. Additional studies, focusing on the involvement of thalamic and limbic structures in the pathophysiology of tinnitus, are needed to support the use of DBS.
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Deep brain stimulation (DBS) of the anterior thalamic complex (ANT) is an adjunctive therapy for pharmacoresistant epilepsy. To define the most efficient target in DBS for epilepsy, we investigate clinical data, position of leads, usability of atlas data compared to electric field modeling based on programming parameters. ⋯ The distance of the active contact to the lateral wall of the third ventricle, MTT and the ventrodorsal distance to midcommissural plane appear to be relevant for optimal target planning. For reduction of focal seizure frequency, we found best response rates with a center of stimulation 5 mm lateral to the wall of the third ventricle, and a lead tip 10 mm dorsal of the midcommissural plane.