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Published on: August 12, 2018
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.
Background And Objectives:
Deep brain stimulation (DBS) is a well-established treatment for Parkinson disease (PD), with programming methods continually evolving. This study aimed to compare the efficacy and patient burden between conventional ring-mode programming (CP-RM) and image-guided volume of tissue activated (IG-VTA) programming for subthalamic nucleus (STN) DBS in PD.
Methods:
In this retrospective study, patients with PD who underwent STN-DBS between 2011 and 2014 (CP-RM group) and 2019 and 2021 (IG-VTA group) were evaluated. The primary outcome was the improvement in the UPDRS III score from preoperative OFF to postoperative ON state without medication at one-year follow-up. Secondary outcomes included hospital stay duration and programming sessions.
Results:
A total of 26 patients were analyzed (IG-VTA: n = 12, CP-RM: n = 14). Both groups showed similar improvements in UPDRS III scores (IG-VTA: 43.62, CP-RM: 41.29). However, the IG-VTA group experienced shorter immediate postoperative hospital stays and fewer hospitalizations after discharge.
Discussion:
IG-VTA programming preserved the clinical efficacy of STN-DBS over 1 year and reduced the patient and clinician burden of hospital stay and programming sessions. However, conclusions drawn must consider the limitations of retrospective design, differing time epochs, and evolving clinical practices. Further multicentric and prospective studies are warranted to validate these findings in the evolving field of neurostimulation.
Trial Registration Information:
The trial is registered on clinicaltrials.gov (NCT05103072).
