Sustained Therapeutic Benefits Using Image-Guided Programming at Activation of Deep Brain Stimulation for Parkinson's Disease.
Sustained Therapeutic Benefits Using Image-Guided Programming at Activation of Deep Brain Stimulation for Parkinson's Disease.
Where did the research take place?
The study site has not been established. Author addresses may differ from where the research occurred.
Spokane, US · Author affiliation
Selkirk Neurology, Spokane, Washington, USA.Location evidence
Tampa, US · Author affiliation
Department of Neurology and Neurosurgery, University of South Florida, Tampa, Florida, USA.Location evidence
Norman, US · Author affiliation
Norman Fixel Institute for Neurological Diseases, Department of Neurology, University of Florida, Gainesville, Florida, USA.Location evidence
San Antonio, US · Author affiliation
Department of Neurology and Neurosurgery, University of Texas San Antonio, San Antonio, Texas, USA.Location evidence
Chicago, US · Author affiliation
Department of Neurology, Northwestern University School of Medicine, Chicago, Illinois, USA.Location evidence
Miami, US · Author affiliation
Department of Neurology and Neurosurgery, University of Miami School of Medicine, Miami, Florida, USA.Location evidence
Hempstead, US · Author affiliation
Department of Neurology, Zucker School of Medicine at Hofstra/Northwell Health, Hempstead, New York, USA.Location evidence
New York City, US · Author affiliation
Department of Neurology, Zucker School of Medicine at Hofstra/Northwell Health, Hempstead, New York, USA.Location evidence
East Meadow, US · Author affiliation
Department of Neurosciences, Nassau University Medical Center, East Meadow, New York, USA.Location evidence
Tucson, US · Author affiliation
Department of Neurosurgery, University of Arizona College of Medicine, Tucson, Arizona, USA.Location evidence
Boston, US · Author affiliation
Boston Scientific Neuromodulation, Valencia, California, USA.Location evidence
Valencia, US · Author affiliation
Boston Scientific Neuromodulation, Valencia, California, USA.Location evidence
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Original abstract
BACKGROUND: The efficacy of deep brain stimulation (DBS) for Parkinson's disease (PD) depends on optimizing stimulation parameters for each patient, a time-sensitive process. Image-guided programming (IGP) offers a promising method to streamline this. OBJECTIVE: The objective was to evaluate the real-world effectiveness of an IGP tool with directional leads during the initial programming of bilateral subthalamic nucleus (STN) or globus pallidus internus (GPi) DBS in PD patients. METHODS: A total of 57 PD patients (46 bilateral STN, 11 bilateral GPi) from the Vercise DBS Registry (NCT#02071134) were enrolled into the GUIDE XT substudy. Time for initial programming using IGP, Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part III at baseline, 6-months, and 1-year postactivation, Global Impression of Change from patients and clinicians, and the continued use of IGP-suggested settings were analyzed. Stimulation field model (SFM) overlap between initial and 1-year target volumes was also examined. RESULTS: Motor function significantly improved at 6 months and 1 year (55% and 45%, P < 0.0001) compared to baseline, as assessed by MDS-UPDRS III (Meds OFF/Stim ON). Initial programming sessions of bilateral leads using IGP (n = 56) lasted 39.4 ± 4.4 minutes (mean ± standard error [SE]), whereas it was completed in less than 30 minutes in 55% of subjects. Contact selection, polarity, and fractionalization determined at initial programing using IGP remained unchanged in 52% and 43% of subjects (n = 21) up to 6 months and 1 year, respectively. The average SFM overlap for all subjects was 92% (SE: 15%) at the 1-year visit. CONCLUSIONS: IGP facilitates efficient initial programming sessions, providing stable settings that result in long-term motor improvements.