Computer-Guided Deep Brain Stimulation Programming for Parkinson's Disease Academic Article uri icon

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abstract

  • OBJECTIVE: Pilot study to evaluate computer-guided deep brain stimulation (DBS) programming designed to optimize stimulation settings using objective motion sensor-based motor assessments. MATERIALS AND METHODS: Seven subjects (five males; 54-71 years) with Parkinson's disease (PD) and recently implanted DBS systems participated in this pilot study. Within two months of lead implantation, the subject returned to the clinic to undergo computer-guided programming and parameter selection. A motion sensor was placed on the index finger of the more affected hand. Software guided a monopolar survey during which monopolar stimulation on each contact was iteratively increased followed by an automated assessment of tremor and bradykinesia. After completing assessments at each setting, a software algorithm determined stimulation settings designed to minimize symptom severities, side effects, and battery usage. RESULTS: Optimal DBS settings were chosen based on average severity of motor symptoms measured by the motion sensor. Settings chosen by the software algorithm identified a therapeutic window and improved tremor and bradykinesia by an average of 35.7% compared with baseline in the "off" state (p < 0.01). CONCLUSIONS: Motion sensor-based computer-guided DBS programming identified stimulation parameters that significantly improved tremor and bradykinesia with minimal clinician involvement. Automated motion sensor-based mapping is worthy of further investigation and may one day serve to extend programming to populations without access to specialized DBS centers.

authors

  • Heldman, Dustin A
  • Pulliam, Christopher L
  • Urrea Mendoza, Enrique
  • Gartner, Maureen
  • Giuffrida, Joseph P
  • Montgomery, Erwin
  • Espay, Alberto J
  • Revilla, Fredy J

publication date

  • February 2016