title: Short pulse width widens the therapeutic window of subthalamic neurostimulation.
abstract: We explored the impact of pulse durations <60 μsec on the therapeutic window of subthalamic neurostimulation in Parkinson's disease. Current thresholds for full rigidity control and first muscle contractions were evaluated at pulse durations between 20 and 120 μsec during a monopolar review session in four patients. The average therapeutic window was 2.16 mA at 60 μsec, which proportionally increased by 182% at 30 μsec, while decreasing by 46% at 120 μsec. Measured chronaxies and model data suggest, that pulse durations <60 μsec lead to a focusing of the neurostimulation effect on smaller diameter axons close to the electrode while avoiding stimulation of distant pyramidal tract fibers.
authors.affiliation: Department of Neurology, Julius-Maximilians-University Würzburg, Germany.
authors.forename: Martin M
authors.initials: MM
authors.lastname: Reich
authors.affiliation: Department of Neurology, Julius-Maximilians-University Würzburg, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Steigerwald
authors.affiliation: Department of Neurology, Julius-Maximilians-University Würzburg, Germany.
authors.forename: Anna D
authors.initials: AD
authors.lastname: Sawalhe
authors.affiliation: Department of Neurology, Julius-Maximilians-University Würzburg, Germany.
authors.forename: Rene
authors.initials: R
authors.lastname: Reese
authors.affiliation: Department of Biomedical Engineering, Case Western Reserve University Cleveland, Ohio.
authors.forename: Kabilar
authors.initials: K
authors.lastname: Gunalan
authors.affiliation: Department of Neurosurgery, Julius-Maximilans-University Würzburg, Germany.
authors.forename: Silvia
authors.initials: S
authors.lastname: Johannes
authors.affiliation: Department of Neurosurgery, Julius-Maximilans-University Würzburg, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Nickl
authors.affiliation: Department of Neurosurgery, Julius-Maximilans-University Würzburg, Germany.
authors.forename: Cordula
authors.initials: C
authors.lastname: Matthies
authors.affiliation: Department of Biomedical Engineering, Case Western Reserve University Cleveland, Ohio.
authors.forename: Cameron C
authors.initials: CC
authors.lastname: McIntyre
authors.affiliation: Department of Neurology, Julius-Maximilians-University Würzburg, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Volkmann