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Constant current stimulation may improve apraxia of eyelid opening induced by deep brain stimulation

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Title: Constant current stimulation may improve apraxia of eyelid opening induced by deep brain stimulation
Authors: Eguchi, Katsuki Browse this author
Yabe, Ichiro Browse this author →KAKEN DB
Shirai, Shinichi Browse this author
Iwata, Ikuko Browse this author
Matsushima, Masaaki Browse this author
Yamazaki, Kazuyoshi Browse this author
Hamauchi, Shuji Browse this author
Sasamori, Toru Browse this author
Seki, Toshitaka Browse this author
Houkin, Kiyohiro Browse this author →KAKEN DB
Sasaki, Hidenao Browse this author →KAKEN DB
Keywords: Apraxia of eyelid opening
Constant current stimulation
Constant voltage stimulation
Deep brain stimulation
Parkinson's disease
Subthalamic nucleus
Issue Date: Mar-2020
Publisher: Elsevier
Journal Title: Interdisciplinary Neurosurgery-advanced Techniques And Case Management
Volume: 19
Start Page: UNSP 100565
Publisher DOI: 10.1016/j.inat.2019.100565
Abstract: Background: Apraxia of eyelid opening (AEO) is a common side effect of subthalamic nucleus deep brain stimulation (STN-DBS) and difficult to treat. We report the case of a patient with Parkinson's disease (PD) whose DBS-induced AEO was alleviated after adjustment from constant-voltage (CV) to constant-current (CC) stimulation. Case description: A female patient with PD underwent bilateral STN-DBS surgery 12 years after onset. Three months after the start of stimulation, she developed bilateral AEO though her motor symptoms improved. Her AEO severity deteriorated in line with an increase in stimulation-voltage. Three years after surgery, we replaced the implantable pulse generators (IPGs) because of low voltage. We changed the stimulation programs from CV stimulation to CC stimulation as only CC stimulation was available on the new IPG model. Her AEO was significantly improved after the stimulation programs were changed from CV to CC stimulation, even though the stimulation intensity did not change markedly. Her motor symptoms did not change. We evaluated the association between AEO severity and stimulation contact point and found that stimulation at the lowest contact on the left side strongly induced AEO. Conclusion: Shifting from CV stimulation to CC stimulation may improve DBS-induced AEO. The exact mechanism underlying this improvement is unknown and further studies are needed to confirm the efficacy of CC stimulation for AEO.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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