Master Theses UMCG - University of Groningen
English | Nederlands

Optimizing Tremor Control by exploring random Combinations of Deep Brain Stimulation Parameters

(2018) Bogdan, D.I.D. (Daria)

Optimal programming of deep brain stimulation (DBS) is essential for deriving the most clinical benefit postoperatively. We showed that despite significant evolution of the stimulation parameters over time (p < .001), there is yet no consensus regarding which stimulation parameters or programming strategies should be employed for optimal titration of DBS for essential tremor (ET). We hypothesize that an empirical approach utilizing random combinations of stimulation parameters can yield better symptom control and reduce side-effects compared to baseline. In this scope, ten random combinations of stimulation parameters were tested in eleven consecutive tremor patients with DBS and documented by means of patient-reported outcomes and accelerometry. The experimental approach showed significantly improved symptom control in both the short- (p = .007) and medium-term (p = .03), providing an individualized, highly effective and time-efficient novel tool for improving DBS programming.

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