Master of Science
Physiology and Pharmacology
Multiple neural network integration, influence of bradykinesia and rigidity, and bias of upper limb symptom improvement during deep brain stimulation implementation may attribute to the variable responsiveness of Parkinsonian gait therapy. Current steering (CS) addresses variability through fractionating current to fine-tune the stimulation field shape. It was hypothesized that CS would exhibit greater gait improvements and lower the total electrical energy delivered (TEED), which reduces power consumption and battery drainage. Divisions of 70/30 and 50/50 and single-contact stimulation modelled CS and conventions, respectively. Overall ambulation improved with TEED reduction; further, bilateral CS improved step time and length but left CS improved stride velocity and the functional ambulation performance score. However, total double support time exhibited no differences. Separate sub-cortical networks may regulate amplitude, timing, and velocity versus balance, and unilateral benefit may elucidate left hemispheric dominance for motor control. Future studies should personalize fractionations to contact localizations for clinical relevancy.
Hui, Daphne, "Investigating the Practical and Clinical Effectiveness of Applying Current Steering to Deep Brain Stimulation for Parkinsonian Gait Therapy" (2018). Electronic Thesis and Dissertation Repository. 5894.