A New Stimulation Mode for Deep Brain Stimulation in Parkinson's Disease: Theta Burst Stimulation

• Published in: Movement disorders Vol. 35; no. 8; pp. 1471 - 1475
• Main Authors: Horn, Martin A., Gulberti, Alessandro, Gülke, Eileen, Buhmann, Carsten, Gerloff, Christian, Moll, Christian K.E., Hamel, Wolfgang, Volkmann, Jens, Pötter‐Nerger, Monika
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01-08-2020; Wiley Subscription Services, Inc
• Subjects: Akinesia; Algorithms; Deep Brain Stimulation; Humans; Movement disorders; Neurodegenerative diseases; Parkinson Disease - therapy; Parkinson's disease; Subthalamic Nucleus; therapeutic window width; theta burst stimulation; Theta rhythms; Transcranial Magnetic Stimulation; Treatment Outcome; Tremor; therapeutic window width; Parkinson's disease; subthalamic nucleus; deep brain stimulation; theta burst stimulation
• ISSN: 0885-3185; 1531-8257
• DOI: 10.1002/mds.28083

Background and Objectives
The purpose of this study was to assess efficacy and safety of a new patterned theta burst stimulation algorithm of DBS with the aim of expanding the therapeutic window and clinical benefit in PD.
Methods
In this single‐center, randomized, double‐blind, clinical short‐term trial, unilateral conventional subthalamic DBS was compared with unilateral patterned stimulation algorithms with intraburst high‐ or low‐frequency theta burst stimulation in 17 PD patients.
Results
There were no serious adverse events with theta burst stimulation. During monopolar review, conventional subthalamic DBS and high‐frequency theta burst stimulation were comparable, but low‐frequency theta burst stimulation differed by requiring higher stimulation amplitudes for symptom reduction, but a larger therapeutic window. High‐ and low‐frequency theta burst stimulation with adapted stimulation amplitude were effective in PD symptom reduction with differential effects on akinesia and tremor, depending on the theta burst stimulation mode.
Conclusions
Theta burst stimulation is a safe and effective stimulation mode with potential future application opportunities. © 2020 International Parkinson and Movement Disorder Society