Interleaving Stimulation With A Combination Of Bipolar And Monopolar Configurations For Secondary Failure Of Bilateral Subthalamic Stimulation In Parkinson'S Disease

Current control technology using interleaving stimulation could be theoretically useful for maximizing the benefits of deep brain stimulation, but it is seldom reported. A 61-year-old man with young-onset Parkinson's disease was previously treated with bilateral subthalamic nucleus deep brain stimulation because of wearing-off and peak-dose dyskinesia; he again developed wearing-off and a gait disturbance 3 years after surgery. His deep brain stimulation was adjusted by utilizing interleaving stimulation with a combination of monopolar and bipolar configurations, because increasing stimulation with single or double monopolar stimulation, and interleaving monopolar stimulation caused pyramidal side-effects. After adjusting deep brain stimulation, his wearing-off symptoms and gait disturbance were markedly improved without any side-effects. The present case report describes the potential of interleaving stimulation with a combination of monopolar and bipolar settings for the treatment of Parkinson's disease.