One of the most recent technological advances in deep brain stimulation (DBS) technology has been the introduction of axial current steering. Until now, the electrical field could only be shaped along the lead axis. Two intraoperative studies with novel lead designs revealed larger therapeutic windows with directional DBS [
- Pollo C.
- Kaelin-Lang A.
- Oertel M.F.
- Stieglitz L.
- Taub E.
- Fuhr P.
- Lozano A.M.
- Raabe A.
- Schüpbach M.
Directional deep brain stimulation: an intraoperative double-blind pilot study.
Brain. 2014; 137: 2015-2026https://doi.org/10.1093/brain/awu102
2], most probably due to the reduction of inadvertent current spread to structures surrounding the stimulation target. DBS leads with two levels of tripartite electrodes capable of conventional circular stimulation (by simultaneous activation of all segments) as well as axial current steering have recently become commercially available for permanent implantation. In a pilot study, an expansion of the therapeutic window using directional stimulation with these leads could be demonstrated [
- Contarino M.F.
- Bour L.J.
- Verhagen R.
- Lourens M.A.J.
- de Bie R.M.A.
- van den Munckhof P.
- Schuurman P.R.
Directional steering: a novel approach to deep brain stimulation.
Neurology. 2014; 83: 1163-1169https://doi.org/10.1212/WNL.0000000000000823
- Steigerwald F.
- Müller L.
- Johannes S.
- Matthies C.
- Volkmann J.
Directional deep brain stimulation of the subthalamic nucleus: a pilot study using a novel neurostimulation device.
Mov. Disord. 2016; (n/a-n/a)https://doi.org/10.1002/mds.26669
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Parkinsonism & Related Disorders
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Directional deep brain stimulation: an intraoperative double-blind pilot study.Brain. 2014; 137: 2015-2026https://doi.org/10.1093/brain/awu102
- Directional steering: a novel approach to deep brain stimulation.Neurology. 2014; 83: 1163-1169https://doi.org/10.1212/WNL.0000000000000823
- Directional deep brain stimulation of the subthalamic nucleus: a pilot study using a novel neurostimulation device.Mov. Disord. 2016; (n/a-n/a)https://doi.org/10.1002/mds.26669
- Tremor response to polarity, voltage, pulsewidth and frequency of thalamic stimulation.Neurology. 2003; 60: 786-790
Published online: August 11, 2016
Received: May 24, 2016
© 2016 Elsevier Ltd. All rights reserved.