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Controlling Parkinson's Disease With Adaptive Deep Brain Stimulation
Published on: July 16, 2014
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Adaptive Deep Brain Stimulation in Parkinson's Disease: A Delphi Consensus Study
M Guidetti1, T Bocci1,2, M De Pedro Del Álamo3
1"Aldo Ravelli" Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Via Antonio di Rudinì 8, 20142 Milan, Italy.
Medrxiv : the Preprint Server for Health Sciences
|September 10, 2024
Summary
Adaptive Deep Brain Stimulation (aDBS) is poised to become standard practice within a decade, offering safer and more effective treatment for Parkinson's disease. Experts anticipate aDBS will provide faster, stable symptom control compared to conventional DBS.
Area of Science:
- Neuroscience
- Neurological Surgery
- Biomedical Engineering
Background:
- Conventional Deep Brain Stimulation (cDBS) has evolved significantly, with adaptive approaches (aDBS) representing the next frontier.
- While aDBS devices are available, data on clinical application and limitations are scarce, necessitating expert consensus.
- The transition from fixed-rate to on-demand cardiac pacing offers a historical parallel for the expected rise of adaptive neuromodulation.
Purpose of the Study:
- To gather global expert opinion on the clinical application and technological challenges of adaptive Deep Brain Stimulation (aDBS).
- To guide and ground the clinical development and practice of aDBS for neurological disorders.
- To establish consensus on the safety, efficacy, and future trajectory of aDBS.
Main Methods:
- A Delphi method was employed, involving a 5-point Likert scale questionnaire.
- Twenty-one experienced Deep Brain Stimulation (DBS) clinicians participated in the study.
- Forty-two questions covering technical and clinical aspects of aDBS were submitted to the expert panel.
Main Results:
- Experts reached consensus that aDBS will be integrated into clinical practice within 10 years.
- The panel agreed on the safety of aDBS and its potential for faster, more stable treatment responses than cDBS.
- aDBS is expected to benefit Parkinson's disease patients with tremor, motor fluctuations, and dyskinesias, though algorithm optimization is needed.
Conclusions:
- Adaptive Deep Brain Stimulation (aDBS) is considered safe and holds promise for maximizing effectiveness in Parkinson's disease (PD) patients.
- Further research is required, particularly in algorithm development and identifying markers for complex PD symptoms.
- aDBS is anticipated to enter widespread clinical practice in the coming years, enhancing PD management.
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