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

Nada Yousif, Nicola Pavese, Mohammad J Naushahi, Dipankar Nandi, Peter G Bain

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

Abstract

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.

Original languageEnglish
JournalNeurocase
Volume20
Issue1
Pages (from-to)10-7
Number of pages8
ISSN1355-4794
DOIs
Publication statusPublished - 2014

Keywords

  • Deep Brain Stimulation
  • Essential Tremor
  • Female
  • Humans
  • Implantable Neurostimulators
  • Middle Aged
  • Models, Neurological
  • Case Reports
  • Journal Article
  • Research Support, Non-U.S. Gov't

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