AI Article Synopsis

  • Symmetric biphasic pulses improve the therapeutic effects of deep brain stimulation (Vim-DBS) for essential tremor (ET) by reducing side effects like ataxia compared to standard cathodic pulses.
  • In a study with 12 ET patients, both pulse types provided similar tremor control during a 3-hour stimulation period.
  • Results showed that biphasic pulses led to significantly less ataxia and improved speech rates, suggesting a better safety profile for this stimulation method in ET treatment.

Article Abstract

Background: Symmetric biphasic pulses have been shown to acutely increase the therapeutic window of ventralis intermedius deep brain stimulation (Vim-DBS) for essential tremor (ET) compared to cathodic pulses. Acute supratherapeutic stimulation can induce ataxic side effects in Vim-DBS.

Objective: To investigate the effect on tremor, ataxia and dysarthria of 3 h of biphasic stimulation in patients with DBS for ET.

Methods: A randomized, doubled-blind, cross-over design was used to compare standard cathodic pulses with symmetric biphasic pulses (anode-first) during a 3-h period per pulse shape. During each 3-h period, all stimulation parameters were identical, except for the pulse shape. Tremor (Fahn-Tolosa-Marin Tremor Rating Scale), ataxia (International Cooperative Ataxia Rating Scale) and speech (acoustic and perceptual measures) were assessed hourly during the 3-h periods.

Results: Twelve ET patients were included. During the 3-h stimulation period, tremor control was equivalent between the two pulse shapes. Biphasic pulses elicited significantly less ataxia than cathodic pulses (p = 0.006). Diadochokinesis rate of speech was better for the biphasic pulse (p = 0.048), but other measures for dysarthria were not significantly different between the pulses.

Conclusion: Symmetric biphasic pulses induce less ataxia than conventional pulses after 3 h of stimulation DBS in ET patients.

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Source
http://dx.doi.org/10.1016/j.parkreldis.2023.105435DOI Listing

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