Objective: Consider the clinical utility of programming method for multi-contact electrodes in Parkinson’s disease (PD) from our experiences.

Background: Some PD patients with deep brain stimulation (DBS) need frequent programming to find appropriate stimulating area. Not only to avoid the side effect of stimulation such as paresthesias, dysarthria or mood changes, but also to provide the optimal effect by the appropriate programming is required. In this study, we will report with findings based on the experience of the programming method for multi-contact electrodes with multiple independent current control (MICC) at the outpatient clinic in our institution.

Method: This is a retrospective study of thirteen PD patients who underwent DBS using eight-contact electrodes with MICC by Boston Scientific Vercise^TM from July 2016 until January 2020. Before DBS, all of these patients were treated by medication but suffering from progressive PD symptoms and adverse effect of drugs such as wearing-off, hallucination, and dyskinesia. The target was either Subthalamic nucleus (STN) or Globus pallidus interna (Gpi), and the better one was selected according to the patient’s symptoms and background. We investigated the appropriate programming method at the outpatient clinic after DBS.

Results: The number of patients who underwent STN and Gpi were seven and six respectively. In nine out of thirteen cases were able to maintain good stimulation effect by the monopolar stimulation using one or two consecutive electrodes during the follow up. On the other hand, the remained four cases occurred poor effect and/or side effects by the stimulation (ex. numbness, uncontrolled tremor etc.). By changing distribution of stimulating intensity with several electrodes independently, that is the feature of MICC, we were able to detect an effective tailor made stimulating pattern and decrease adverse responses.

Conclusion: The findings from our experience is that multi-contact electrodes with MICC is useful not only to enhance the effect of DBS but maintain the effect for long time. Although it is a time consuming procedure to determine the optimal stimulation and it may require trial and error adjustments, combination with MICC will produce more effective stimulation patterns.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-clinical-utility-of-programming-method-for-multi-contact-electrodes-of-deep-brain-stimulation-in-parkinsons-disease/