Category: Surgical Therapy: Parkinson's Disease
Objective: In this study we aimed to investigate and compare the utility of conventional DBS programming strategies and anatomically informed approaches predicting long term motor outcome in subthalamic DBS for Parkinson’s disease (PD-STN-DBS).
Background: Conventional DBS programming via tedious and time-consuming trial-and-error demands further improvement to ensure swift achievement of optimal outcomes. Converging evidence points to an anatomic definition of a sweet spot for PD-STN-DBS (e.g. [1]).
Method: We compared contact selection based on monopolar review (MCS) to anatomically informed contact selection (ACS) in a cohort of 29 PD patients with STN-DBS (n = 54 hemispheres). A commercially available software package was employed for contact selection based on visual assessment of individual anatomy (vACS) following a closely defined strategy, as well as an algorithmic approach optimizing contact selection for sweet spot targeting (aACS). Similarity indices (Dice coefficients) between chronic stimulation settings at 12 months follow-up and contact selection strategies were correlated to long term motor outcomes.
Results: ACS resulted in superior sweet spot coverage compared to MCS. Beneficial lateralized motor outcome (UPDRS III hemiscore) of chronic DBS was significantly correlated to higher Dice coefficients for vACS (rho = 0.3, p = 0.02, Figure 1 D/E). Similar relationships could not be established for MCS and aACS (Figure 1 C/F).
Conclusion: Anatomically informed contact selection based on visual assessment correlates with beneficial long term motor outcome in PD STN DBS and may be superior to conventional monopolar review.
References: [1] Dembek TA, Roediger J, Horn A, et al. Probabilistic sweet spots predict motor outcome for deep brain stimulation in Parkinson disease. Ann Neurol. 2019;86(4):527-538. doi:10.1002/ana.25567
To cite this abstract in AMA style:
GA. Brandt, V. Stopic, C. Hennen, JN. Strelow, JN. Petry-Schmelzer, JC. Baldermann, MT. Barbe, V. Visser-Vandevalle, TA. Dembek. Moving beyond trial and error: a strategy for anatomically informed contact selection in subthalamic deep brain stimulation for Parkinson’s disease. [abstract]. Mov Disord. 2023; 38 (suppl 1). https://www.mdsabstracts.org/abstract/moving-beyond-trial-and-error-a-strategy-for-anatomically-informed-contact-selection-in-subthalamic-deep-brain-stimulation-for-parkinsons-disease/. Accessed July 5, 2025.« Back to 2023 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/moving-beyond-trial-and-error-a-strategy-for-anatomically-informed-contact-selection-in-subthalamic-deep-brain-stimulation-for-parkinsons-disease/