Establishment of a Visual Analog Scale for DBS Programming (VISUAL-STIM Trial)

Area of Science:

• Neurological Surgery
• Biomedical Engineering
• Movement Disorders

Background:

• Deep brain stimulation (DBS) is a standard treatment for Parkinson's disease, essential tremor, and dystonia.
• Effective programming of DBS devices is crucial for clinical outcomes.
• Current DBS programming methods are time-consuming and resource-intensive.

Purpose of the Study:

• To evaluate the utility of patient-rated visual analog scale (VAS) for real-time adjustment of DBS parameters.
• To compare VAS-based programming with classical, clinically-based programming strategies.

Main Methods:

• The study involved 17 Parkinson's patients receiving subthalamic nucleus DBS (STN-DBS).
• Stimulation parameters (contact and amplitude) were optimized using patient VAS ratings.
• Minkowski distance was used to compare VAS-based and classical programming outcomes.

Main Results:

• No statistically significant differences were found between VAS-based and classical programming regarding stimulation parameters.
• Clinical disease severity (UPDRS scores) showed no significant difference between the two programming methods.
• Both methods yielded similar short-term clinical outcomes.

Conclusions:

• VAS-based and classical DBS programming strategies produce comparable short-term results.
• Patient subjective ratings, like VAS, show potential as a valid feedback signal for individualized DBS.
• Further research is needed to confirm the long-term validity of VAS-based DBS programming.