Objective: This pilot study aimed to assess the therapeutic potential of chronically implanted directional DBS leads in patients with Parkinson’s disease.

Background: The therapeutic effect of deep brain stimulation (DBS) in the subthalamic nucleus is frequently limited by side-effects resulting from unintended stimulation of neighboring areas. Recently available chronically implantable DBS leads capable of directional steering might overcome this problem.

Methods: Randomized, double-blinded, standardized monopolar reviews were conducted in consecutive patients, about one week after implantation of a novel DBS system capable of directional stimulation. Clinical effects and side-effect thresholds were compared between unidirectional and circular DBS. After a two-day double-blind crossover phase, patients were asked to opt for either circular or unidirectional DBS.

Results: Unidirectional DBS offered increased side-effect thresholds compared to circular DBS depending on stimulation direction. Highest side-effect thresholds were achieved with posteromedial or anterior stimulation in most cases.

Conclusions: This pilot study provides preliminary evidence for advantages of directional DBS systems. Large cohorts with long-term follow-up are needed to confirm these results.

Preliminary data have been presented at the II. International Conference on Deep Brain Stimulation (DBS), March 2016, Duesseldorf, Germany.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/chronic-directional-subthalamic-nucleus-deep-brain-stimulation-in-parkinsons-disease-a-pilot-study/