4.1 Article

Reversing the polarity of bipolar stimulation in deep brain stimulation for essential tremor: A theoretical explanation for a useful clinical intervention

期刊

NEUROCASE
卷 20, 期 1, 页码 10-17

出版社

ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD
DOI: 10.1080/13554794.2012.713495

关键词

Tremor; Electrical stimulation; Neurosurgery; Computational modelling; Parameter settings

资金

  1. BUPA foundation
  2. Medical Research Council, UK
  3. MRC [G1100810, MC_U120036861, G0701698, G0600168] Funding Source: UKRI
  4. Medical Research Council [G1100810, G0701698, G0600168, MC_U120036861] Funding Source: researchfish

向作者/读者索取更多资源

The quadripolar electrodes used for deep brain stimulation are designed to give flexibility in contact configuration, optimize therapeutic effect, and minimize side-effects. A patient with essential tremor did not tolerate a bipolar setting due to the emergence of a pulling sensation in her face. However, when the polarity of the contacts was reversed, a 70% higher voltage was tolerated. Using an electric field model, we predicted that this effect was due to the proximity of the topmost contact to the internal capsule. Post-operative imaging supported this prediction. These results demonstrate how a multi-disciplinary approach allows us to optimize parameter settings.

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