DIPS (Dystonia Image-based Programming of Stimulation: a prospective, randomized, double-blind crossover trial)
Florian Lange1, Jonas Roothans2, Tim Wichmann2
1Department of Neurology, University Hospital and Julius Maximilian University, Josef-Schneider-Straße 11, 97080, Würzburg, Germany. Lange_L@ukw.de.
Neurological Research and Practice
|December 20, 2021
Summary
Computer-guided deep brain stimulation (DBS) programming may optimize treatment for dystonia by predicting the best stimulation parameters. This approach aims to improve outcomes and reduce programming time for patients receiving pallidal DBS therapy.
Area of Science:
- Neuroscience
- Neurology
- Biomedical Engineering
Background:
- Deep brain stimulation (DBS) of the internal globus pallidus is effective for dystonia, but outcomes vary significantly.
- Up to 25% of patients do not respond to pallidal DBS, even with primary dystonia.
- Variability in outcomes is linked to the precise location and stimulation volume within the pallidal region.
Purpose of the Study:
- To test a novel computer-based approach for predicting optimal deep brain stimulation (DBS) parameters in dystonia patients.
- To compare the efficacy of model-predicted DBS settings against standard clinical programming.
- To reduce the time and effort required for programming DBS in dystonia.
Main Methods:
- Developed probabilistic maps of anti-dystonic effects from over 80 patients' multi-center data.
- Modified algorithms to test all possible stimulation settings in silico for new patients.
- Conducted a randomized, controlled crossover study to compare model-predicted vs. best clinical settings using blinded physician ratings.
Main Results:
- The primary endpoint is successful treatment defined by motor symptom improvement with model-predicted settings compared to clinical settings.
- Secondary endpoints include quality of life, energy consumption, and physician programming time.
- The study protocol is designed to determine the superiority of computer-guided programming.
Conclusions:
- Computer-guided in silico deep brain stimulation (DBS) programming offers a potential method for optimizing stimulation settings in dystonia patients.
- This approach may eliminate the need for lengthy programming sessions, improving patient experience.
- The study will evaluate the effectiveness of model-predicted settings versus best clinical settings for dystonia symptom control and quality of life.
