Reduced Programming Time and Strong Symptom Control Even in Chronic Course Through Imaging-Based DBS Programming

Florian Lange, Frank Steigerwald, Tobias Malzacher, Gregor Alexander Brandt, Thorsten Michael Odorfer, Jonas Roothans, Martin M. Reich, Patrick Fricke, Jens Volkmann, Cordula Matthies, Philipp D. Capetian
2021 Frontiers in Neurology  
Objectives: Deep brain stimulation (DBS) programming is based on clinical response testing. Our clinical pilot trial assessed the feasibility of image-guided programing using software depicting the lead location in a patient-specific anatomical model.Methods: Parkinson's disease patients with subthalamic nucleus-DBS were randomly assigned to standard clinical-based programming (CBP) or anatomical-based (imaging-guided) programming (ABP) in an 8-week crossover trial. Programming characteristics
more » ... nd clinical outcomes were evaluated.Results: In 10 patients, both programs led to similar motor symptom control (MDS-UPDRS III) after 4 weeks (medicationOFF/stimulationON; CPB: 18.27 ± 9.23; ABP: 18.37 ± 6.66). Stimulation settings were not significantly different, apart from higher frequency in the baseline program than CBP (p = 0.01) or ABP (p = 0.003). Time spent in a program was not significantly different (CBP: 86.1 ± 29.82%, ABP: 88.6 ± 29.0%). Programing time was significantly shorter (p = 0.039) with ABP (19.78 ± 5.86 min) than CBP (45.22 ± 18.32).Conclusion: Image-guided DBS programming in PD patients drastically reduces programming time without compromising symptom control and patient satisfaction in this small feasibility trial.
doi:10.3389/fneur.2021.785529 fatcat:zqxbjnqrbbbsbhwkhkidbntjnm