Session Information
Date: Thursday, June 8, 2017
Session Title: Parkinson’s Disease: Clinical Trials, Pharmacology And Treatment
Session Time: 1:15pm-2:45pm
Location: Exhibit Hall C
Objective: Recently the EARLYSTIM study showed the superior effect of subthalamic stimulation to best medical treatment in Parkinson`s disease with early motor complications.
Background: EARLYSTIM patients were implanted and programmed in highly specialized DBS centers in Germany and France according to current and common guidelines for all the centers but customized for each patient.
Methods: Statistical analysis of DBS-programming was performed in the cohort of 114 patients with bilateral programming at the 12 and 24 month visits. We investigated the influence of atypical programming (non-unipolar, frequency other than 130 Hz and impulse-width other than 60µs), change of contact and energy changes in the course of stimulation in relation to clinical outcome. The influence of baseline characteristics was also assessed.
Results: The mean stimulation energy (TEED, total electrical energy delivered) increased on both sides over time. The second highest contact was used mostly. Unipolar programming (using one single contact) was sufficient in more than 80% of leads. TEED was significantly higher on the initially affected side. There was no statistically significance between the patient group needing contact changes (n=32, 28.1%) or not regarding outcomes (UPDRS II worst-mobility and total, PDQ-39 mobility and ADL subscores). Additionally, we did not find a significant influence of typical (n=83; 72.8%) versus non-typical programming. Interestingly there was no significant difference in TEED for the first implanted versus second implanted side. We found higher TEED in the patient group with less improvement of the PDQ-39 (≤20%).
Conclusions: Monopolar stimulation using one single contact was found sufficient for optimal treatment for the majority of EARLYSTIM patients. The more affected side and patients with lower improvement of life quality were associated with higher stimulation energy. Although the study was not designed to compare different stimulation regimens, these results emphasize that experienced programming can provide homogeneous results.
To cite this abstract in AMA style:
K. Knudsen, J.-L. Houeto, P. Krack, J. Rau, C. Schade-Brittinger, A. Schnitzler, W.M.M. Schuepbach, L. Timmermann, L. Tonder, G. Deuschl. Programming of deep brain stimulators in Parkinson’s disease with early motor complications (EARLYSTIM-study) [abstract]. Mov Disord. 2017; 32 (suppl 2). https://www.mdsabstracts.org/abstract/programming-of-deep-brain-stimulators-in-parkinsons-disease-with-early-motor-complications-earlystim-study/. Accessed June 14, 2025.« Back to 2017 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/programming-of-deep-brain-stimulators-in-parkinsons-disease-with-early-motor-complications-earlystim-study/