Enhancing Asleep Deep Brain Stimulation Targeting for Essential Tremor Using Machine Learning: The OPTIVIM Phase 2...

Area of Science:

• Neurosurgery
• Neurology
• Medical Imaging

Background:

• Deep brain stimulation (DBS) is a key treatment for essential tremor.
• Optimal targeting and accurate electrode placement for DBS remain challenging.
• The OptimDBS algorithm uses MRI data to predict effective DBS targets.

Purpose of the Study:

• To evaluate the efficacy and safety of asleep DBS guided by the OptimDBS algorithm.
• To assess OptimDBS performance in an independent patient cohort without intraoperative controls.

Main Methods:

• Prospective, single-arm, multicenter Phase 2 trial (OPTIVIM study).
• 22 patients underwent asleep DBS guided by OptimDBS.
• Primary outcome: Fahn-Tolosa-Marin scale at 3 months post-surgery.

Main Results:

• Significant improvement in Fahn-Tolosa-Marin scores (61.3%).
• Substantial reduction in tremor amplitude (81% right, 84% left) via accelerometry.
• No serious adverse events reported; active contacts localized to effective target areas.

Conclusions:

• OptimDBS-guided asleep DBS demonstrates comparable efficacy to existing DBS and ablative techniques.
• Further long-term studies with larger cohorts are recommended for confirmation.