AUTHOR=Lange Florian , Steigerwald Frank , Malzacher Tobias , Brandt Gregor Alexander , Odorfer Thorsten Michael , Roothans Jonas , Reich Martin M. , Fricke Patrick , Volkmann Jens , Matthies Cordula , Capetian Philipp D. 

TITLE=Reduced Programming Time and Strong Symptom Control Even in Chronic Course Through Imaging-Based DBS Programming

JOURNAL=Frontiers in Neurology

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.785529

DOI=10.3389/fneur.2021.785529

ISSN=1664-2295

ABSTRACT=<p><bold>Objectives:</bold> Deep brain stimulation (DBS) programming is based on clinical response testing. Our clinical pilot trial assessed the feasibility of image-guided programing using software depicting the lead location in a patient-specific anatomical model.</p><p><bold>Methods:</bold> Parkinson's disease patients with subthalamic nucleus-DBS were randomly assigned to standard clinical-based programming (CBP) or anatomical-based (imaging-guided) programming (ABP) in an 8-week crossover trial. Programming characteristics and clinical outcomes were evaluated.</p><p><bold>Results:</bold> In 10 patients, both programs led to similar motor symptom control (MDS-UPDRS III) after 4 weeks (medicationOFF/stimulationON; CPB: 18.27 ± 9.23; ABP: 18.37 ± 6.66). Stimulation settings were not significantly different, apart from higher frequency in the baseline program than CBP (<italic>p</italic> = 0.01) or ABP (<italic>p</italic> = 0.003). Time spent in a program was not significantly different (CBP: 86.1 ± 29.82%, ABP: 88.6 ± 29.0%). Programing time was significantly shorter (<italic>p</italic> = 0.039) with ABP (19.78 ± 5.86 min) than CBP (45.22 ± 18.32).</p><p><bold>Conclusion:</bold> Image-guided DBS programming in PD patients drastically reduces programming time without compromising symptom control and patient satisfaction in this small feasibility trial.</p>