Category: Surgical Therapy: Parkinson's Disease
Objective: The aim of this study was to clarify the long-term outcome of Parkinson’s disease patients receiving STN-DBS with adaptive DBS setting.
Background: It has been reported that during the off-phase of Parkinson’s disease (PD) motor symptoms, beta band local potentials (LFPs) are observed in the basal ganglia. Adaptive deep brain stimulation (DBS) utilises a sensing technique that measures LFPs from electrodes implanted in the target nuclei and automatically controls the stimulation programme. In this study, the long-term results of STN-DBS in an adaptive setting were investigated.
Method: We include ten patients who were received STN-DBS with Medtronic Percept PC, adaptive DBS compatible neurostimulator and Medtronic DBS leads. Four patients were first treated with conventional DBS and were set up to adaptive DBS setting at their exchange to Percept PC IPG(group A). Six underwent STN-DBS implantation with adaptive DBS-compatible devices (group B). Their devices were programmed with adaptive settings from the start of treatment. Motor scores evaluated by UPDRS-III and stimulation programs were evaluated at 1, 3, 6, and 12 months after adaptive settings.
Results: In 17 out of 20 electrodes, beta-band LFPs were observed during the off-state of motor symptoms, and disappeared in the on-state. Adaptive DBS was set by tracking the beta-LFP power. The current value was reduced to 65.5+/-30.5% of that in conventional program in group A, with no alteration in motor scores. Stimulus-induced dysphonia improved in two patients after the change to adaptive settings. By contrast, in group B, current values were increased by 33.3% (0.75+/-0.33 to 1.02+/-0.42 mA) at one month postoperatively compared with those measured just after the implantation, with no deterioration in motor scores.
Conclusion: Adaptive DBS using beta-band LFP sensing technology can reduce the stimulation power in chronic phase compared with the conventional DBS settings in chronic states. During the postoperative acute phase, current value was automatically adjusted according to the increased power demand due to loss of micro lesioning effect of the surgery to maintain the motor function. Adaptive DBS is expected to improve the QOL of PD patients. The present study was based on a small number of cases, a larger scale and longer-term study is desirable.
To cite this abstract in AMA style:K. Kimura, H. Kishida, N. Ueda, F. Tanaka. Long-term outcome of adaptive DBS using LFP sensing technology [abstract]. Mov Disord. 2022; 37 (suppl 2). https://www.mdsabstracts.org/abstract/long-term-outcome-of-adaptive-dbs-using-lfp-sensing-technology/. Accessed September 22, 2023.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/long-term-outcome-of-adaptive-dbs-using-lfp-sensing-technology/