A model predicting optimal parameters for deep brain stimulation in essential tremor

Scott E. Cooper, Alexis M. Kuncel, Barbara R. Wolgamuth, Ali R. Rezai, Warren M. Grill

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

In nine patients with essential tremor (14 thalami), the authors varied frequency, voltage, and pulsewidth of thalamic deep brain stimulation, and quantified postural tremor. Low frequency stimulation aggravated tremor; the effect increased with increasing voltage. High frequency stimulation had a U-shaped relation to voltage, with minimum tremor at an optimal voltage characteristic of the individual thalamus and increases in voltage beyond the optimum reduced tremor suppression.Based on the hypothesis that tremor response to deep brain stimulation resulted from two competing processes, the authors successfully modeled the relationship of tremor to voltage and frequency of stimulation using a mathematical model. The optimum voltage predicted by the model agreed with the empirically measured value. Moreover, the model made accurate predictions at high stimulation frequency based on measurements made at low stimulation frequency.Our results indicate there is an optimal voltage for tremor suppression by thalamic deep brain stimulation in most patients with essential tremor. The optimum varies across patients, and this is related to electrode position. A mathematical model based on "competing processes" successfully predicts optimum voltage in individual patients. This supports a competing processes model of deep brain stimulation effects.

Original languageEnglish (US)
Pages (from-to)265-273
Number of pages9
JournalJournal of Clinical Neurophysiology
Volume25
Issue number5
DOIs
StatePublished - Oct 2008

Keywords

  • Deep brain stimulation
  • Essential tremor
  • Movement disorders
  • Surgery
  • Thalamic stimulation
  • Thalamus

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