Imaging-Guided Subthalamic Nucleus Deep Brain Stimulation Programming for Parkinson Disease
A Real-Life Pilot Study
Abstract
Background and Objectives
Deep brain stimulation (DBS) is a well-established treatment for Parkinson disease (PD), with programming methods continually evolving. This study aimed to compare the efficacy and patient burden between conventional ring-mode programming (CP-RM) and image-guided volume of tissue activated (IG-VTA) programming for subthalamic nucleus (STN) DBS in PD.
Methods
In this retrospective study, patients with PD who underwent STN-DBS between 2011 and 2014 (CP-RM group) and 2019 and 2021 (IG-VTA group) were evaluated. The primary outcome was the improvement in the UPDRS III score from preoperative OFF to postoperative ON state without medication at one-year follow-up. Secondary outcomes included hospital stay duration and programming sessions.
Results
A total of 26 patients were analyzed (IG-VTA: n = 12, CP-RM: n = 14). Both groups showed similar improvements in UPDRS III scores (IG-VTA: 43.62, CP-RM: 41.29). However, the IG-VTA group experienced shorter immediate postoperative hospital stays and fewer hospitalizations after discharge.
Discussion
IG-VTA programming preserved the clinical efficacy of STN-DBS over 1 year and reduced the patient and clinician burden of hospital stay and programming sessions. However, conclusions drawn must consider the limitations of retrospective design, differing time epochs, and evolving clinical practices. Further multicentric and prospective studies are warranted to validate these findings in the evolving field of neurostimulation.
Trial Registration Information
The trial is registered on clinicaltrials.gov (NCT05103072).
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Information & Authors
Information
Published In
Neurology® Clinical Practice
Volume 14 • Number 6 • December 2024
Copyright
© 2024 American Academy of Neurology.
Publication History
Received: November 30, 2023
Accepted: April 2, 2024
Published online: September 11, 2024
Published in print: December 2024
Disclosure
M. Lefranc is a consultant for Boston Scientific, Medtronic, Brainlab, and Zimmer Biomed. M. Tir is a consultant for Boston Scientific. There are no other conflicts of interest specifically related to this manuscript. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.
Study Funding
The authors report no targeted funding.
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