Self-adjustment of deep brain stimulation delays optimization in Parkinson's disease

Lais M Oliveira; Marta Ruiz-Lopez; Alexandre Boutet; Gavin J B Elias; Suneil K Kalia; Mojgan Hodaie; Andres M Lozano; Renato P Munhoz; Alfonso Fasano

doi:10.1016/j.brs.2021.04.001

Self-adjustment of deep brain stimulation delays optimization in Parkinson's disease

Brain Stimul. 2021 May-Jun;14(3):676-681. doi: 10.1016/j.brs.2021.04.001. Epub 2021 Apr 11.

Authors

Lais M Oliveira¹, Marta Ruiz-Lopez², Alexandre Boutet³, Gavin J B Elias⁴, Suneil K Kalia⁵, Mojgan Hodaie⁵, Andres M Lozano⁵, Renato P Munhoz⁶, Alfonso Fasano⁷

Affiliations

¹ Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada.
² Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada; Neurology Department, Cruces University Hospital, Barakaldo, Bizkaia, Spain.
³ Division of Neurosurgery, University Health Network, University of Toronto, Toronto, Ontario, Canada; Joint Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.
⁴ Division of Neurosurgery, University Health Network, University of Toronto, Toronto, Ontario, Canada.
⁵ Division of Neurosurgery, University Health Network, University of Toronto, Toronto, Ontario, Canada; Krembil Brain Institute, Toronto, Ontario, Canada; CenteR for Advancing Neurotechnological Innovation to Application (CRANIA), Toronto, ON, Canada.
⁶ Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada; Krembil Brain Institute, Toronto, Ontario, Canada.
⁷ Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada; Krembil Brain Institute, Toronto, Ontario, Canada; CenteR for Advancing Neurotechnological Innovation to Application (CRANIA), Toronto, ON, Canada. Electronic address: alfonso.fasano@uhn.ca.

PMID: 33852934
DOI: 10.1016/j.brs.2021.04.001

Abstract

Background: Parkinson's Disease patients undergo time-consuming programming to refine stimulation parameters after deep brain stimulation surgery.

Objective: To assess whether the use of the advanced functions of a patient's programmer would facilitate programming of deep brain stimulation.

Methods: Thirty patients were randomly allocated to the use of advanced versus simple mode of the patient programmer in this single-centre, prospective, randomized, controlled study. Primary outcome was the number of days required to optimize the stimulation settings.

Results: The number of days required to optimize stimulation was significantly lower in the simple mode (88.5 ± 33.1 vs. 142.1 ± 67.4, p = 0.01). In addition, the advanced mode group had a higher number of side effects (5.4 ± 3.1 vs. 2.6 ± 1.9, p = 0.0055).

Conclusions: The use of the advanced functions of patient programmer delays programming optimization and it is associated with a higher number of side effects. These findings highlight the need for other methods for faster and safer stimulation programming.

Keywords: Deep brain stimulation; Parkinson disease; Programming; Surgery; Therapy.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Deep Brain Stimulation*
Humans
Parkinson Disease* / therapy
Prospective Studies
Treatment Outcome