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Analysis of stimulus parameters for ...

Duke University.

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Analysis of stimulus parameters for thalamic deep brain stimulation.

紀錄類型:	書目-語言資料,印刷品 : Monograph/item
正題名/作者:	Analysis of stimulus parameters for thalamic deep brain stimulation./
作者:	Kuncel, Alexis Marie.
面頁冊數:	152 p.
附註:	Adviser: Warren M. Grill.
Contained By:	Dissertation Abstracts International69-07B.
標題:	Biology, Neuroscience. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoeng/servlet/advanced?query=3321838
ISBN:	9780549717898

Analysis of stimulus parameters for thalamic deep brain stimulation.
Kuncel, Alexis Marie.

Analysis of stimulus parameters for thalamic deep brain stimulation. - 152 p.

Adviser: Warren M. Grill.

Thesis (Ph.D.)--Duke University, 2007.

Addressing these challenges and developing rational methods of selecting stimulation parameters ensures that DBS is an effective treatment and supports the development of new applications.

ISBN: 9780549717898Subjects--Topical Terms:

1017680
Biology, Neuroscience.

Analysis of stimulus parameters for thalamic deep brain stimulation.
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100 1 $a Kuncel, Alexis Marie. $3 1025270
245 1 0 $a Analysis of stimulus parameters for thalamic deep brain stimulation.
300 $a 152 p.
500 $a Adviser: Warren M. Grill.
500 $a Source: Dissertation Abstracts International, Volume: 69-07, Section: B, page: 4290.
502 $a Thesis (Ph.D.)--Duke University, 2007.
520 $a Addressing these challenges and developing rational methods of selecting stimulation parameters ensures that DBS is an effective treatment and supports the development of new applications.
520 $a Deep brain stimulation (DBS) is an effective treatment for movement disorders including essential tremor (ET) and Parkinson's disease. The efficacy of DBS is dependent on properly programmed stimulation parameters and electrode geometry. However, there are presently few guidelines to assist clinicians with DBS programming, and it is a time consuming process. The goal of this work was to address the challenges to developing rational methods of stimulus parameter selection for thalamic DBS to treat ET.
520 $a The large number of combinations of stimulation parameters complicates DBS programming. Knowledge of the relationships between the stimulation parameters (pulse width, frequency, and voltage) and the clinical response can be used to limit the number of combinations. The amount of tremor suppression did not increase as frequency was increased above 100 Hz, but side effects occurred at lower voltages. For each thalamus, there was an optimal voltage at which tremor suppression was maximal, and further increasing voltage reduced clinical efficacy. Finally, pulse width was the least important parameter. These relationships revealed that the number of stimulus parameter combinations to be considered during programming can be reduced by 99%. A reduction in the number of combinations enables more rapid selection of effective parameters.
520 $a Further complicating the selection of stimulation parameters are the unknown mechanisms by which DBS alleviates symptoms. One hypothesis is that DBS acts by regularizing pathological firing patterns of neurons. The effect of stimulation parameters on regularity of neuronal firing patterns was measured in a computational model. The response of neuronal firing patterns paralleled the response of tremor to changing stimulation frequency and amplitude. High frequency stimulation regularized firing patterns and suppressed tremor, and low frequency stimulation decreased regularity of firing patterns and aggravated tremor. The similarity between the clinical and model responses supports the regularization hypothesis. The implication of this mechanism is that a critical stimulation frequency is required to regularize neuronal firing patterns, and increasing stimulation frequency beyond the critical frequency will not further suppress symptoms. Also, the stimulation amplitude must be adjusted so that a sufficient number of neurons are regularized in their firing patterns.
520 $a Another challenge to selecting the stimulation parameters is that the volume of tissue activated during stimulation is presently unknown in thalamic DBS. A method to estimate the spatial extent of activation in thalamic DBS was developed and the amplitude-distance constant was calculated. Knowing the spatial extent of activation will aid in selection of the active contact and voltage, both of which control directly the volume of tissue activated.
590 $a School code: 0066.
650 4 $a Biology, Neuroscience. $3 1017680
650 4 $a Engineering, Biomedical. $3 1017684
650 4 $a Health Sciences, Medicine and Surgery. $3 1017756
690 $a 0317
690 $a 0541
690 $a 0564
710 2 $a Duke University. $3 569686
773 0 $t Dissertation Abstracts International $g 69-07B.
790 $a 0066
790 1 0 $a Grill, Warren M., $e advisor
791 $a Ph.D.
792 $a 2007
856 4 0 $u http://pqdd.sinica.edu.tw/twdaoeng/servlet/advanced?query=3321838