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Controlling Parkinson's Disease With Adaptive Deep Brain Stimulation
Published on: July 16, 2014
Comparative Motor Outcomes and Programming Timelines After Deep Brain Stimulation for Parkinson's Disease With Abbott
Patrick Pema1, Triston Messer2, Jake Barsch2
1Neurosurgery, Hackensack Meridian Health, Hackensack, USA.
Abstract:
Introduction Deep brain stimulation (DBS) is an established therapy for the management of advanced Parkinson's disease, contributing to improvements in motor symptoms and quality of life. Medtronic Percept™ (Medtronic plc, Galway, Ireland) and Abbott Infinity™ (Abbott Laboratories, Abbott Park, Illinois, United States) DBS systems are both widely used by clinicians yet lack real-world head-to-head comparisons of postoperative outcomes. This study evaluated motor outcomes, dopamine challenge responsiveness, cognitive baseline measures, and time to initial programming of patients implanted with Medtronic versus Abbott DBS systems. Methods We performed an exploratory retrospective cohort study of patients with Parkinson's disease who underwent primary DBS implantation with either the Abbott Infinity or Medtronic Percept systems between October 2021 and November 2024 at Jersey Shore University Medical Center, New Jersey, United States. Thirty-nine patients were screened, of whom six were excluded for not meeting inclusion criteria, leaving 33 patients for analysis. Between-group comparisons were performed using nonparametric tests. Longitudinal postoperative Unified Parkinson's Disease Rating Scale Part III (UPDRS) motor scores were evaluated using a generalized estimating equation model accounting for repeated measurements within patients and adjusting for baseline UPDRS Part III score. Exploratory within-group comparisons were performed using Wilcoxon signed-rank tests with Holm correction for multiple comparisons. Results A total of 33 patients met inclusion criteria; these included 10 Abbott Infinity and 23 Medtronic Percept recipients. Baseline characteristics were similar between groups, including age, sex, and preoperative UPDRS motor scores. Postoperative UPDRS motor scores did not differ significantly between patients with Abbott Infinity or Medtronic Percept at three months, six months, nine months, or 12 months. Longitudinal analysis demonstrated no significant device-by-time interaction (p = 0.608). At 12 months, median UPDRS motor score was 10.5 in the Abbott group and 8.0 in the Medtronic group (p = 0.969). Dopamine challenge OFF scores, ON scores, percent improvement, baseline Dementia Rating Scale scores, and time to initial programming were also not significantly different between groups. Median time to initial programming was 27.5 days for Abbott Infinity and 25.0 days for Medtronic Percept (p = 0.317). Conclusion In this single-center exploratory retrospective cohort, no statistically significant differences were detected between Abbott Infinity and Medtronic Percept DBS systems in postoperative motor outcome trajectories, dopamine challenge profiles, baseline cognitive measures, or time to initial programming. Given the small and imbalanced cohort, these findings should not be interpreted as demonstrating equivalence between devices. Larger, longer-term prospective multi-center studies are needed to determine whether clinically meaningful device-specific differences exist.
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