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Imaging-Guided Subthalamic Nucleus Deep Brain Stimulation Programming for Parkinson Disease: A Real-Life Pilot Study
Mickael Aubignat1, Alexis Berro1, Mélissa Tir1
1Department of Neurology (MA, AB, MT); Expert Center for Parkinson's Disease (MA, AB, MT, ML); Department of Neurosurgery (ML), Amiens Picardie University Hospital; Research Unit in Robotic Surgery (GRECO) (ML); and Research Unit UR-7516 (CHIMERE) Research Team for Head and Neck (ML), Institute Faire Faces, University of Picardie Jules Verne, Amiens, France.
Image-guided volume of tissue activated (IG-VTA) programming for subthalamic nucleus deep brain stimulation in Parkinson disease maintains efficacy while reducing patient burden. This method offers shorter hospital stays and fewer programming sessions compared to conventional methods.
Area of Science:
- Neurosurgery
- Neurology
- Medical Technology
Background:
- Deep brain stimulation (DBS) is a key treatment for Parkinson disease (PD).
- Programming techniques for DBS are continuously advancing.
- Subthalamic nucleus (STN) DBS is a common intervention for PD.
Purpose of the Study:
- To compare the efficacy of image-guided volume of tissue activated (IG-VTA) programming versus conventional ring-mode programming (CP-RM) for STN-DBS in PD patients.
- To evaluate the impact of IG-VTA programming on patient and clinician burden, including hospital stay and programming sessions.
Main Methods:
- Retrospective analysis of 26 Parkinson disease patients undergoing STN-DBS.
- Comparison between patients programmed with CP-RM (2011-2014) and IG-VTA (2019-2021).
- Primary outcome: UPDRS III score improvement at one-year follow-up; Secondary outcomes: hospital stay duration and number of programming sessions.
Main Results:
- Both IG-VTA and CP-RM groups demonstrated comparable improvements in UPDRS III scores (43.62 vs. 41.29).
- The IG-VTA group experienced significantly shorter immediate postoperative hospital stays.
- Fewer hospitalizations and programming sessions were observed in the IG-VTA group.
Conclusions:
- IG-VTA programming for STN-DBS in Parkinson disease is clinically effective over one year.
- IG-VTA programming reduces the burden associated with hospital stays and programming sessions.
- Further prospective, multicentric studies are recommended to validate these findings.
