Category: Technology
Objective: To describe utilization of image-guided programming for use as a deep brain stimulation (DBS) planning tool during initial device programming in a cohort of subjects with Parkinson’s disease (PD).
Background: Optimization of DBS programming consists of an empirical trial-and-error process which appraises various stimulation parameters to determine the optimal clinical settings. This process can be inefficient, lengthy, and burdensome. The use of an image-guided programming platform (visualization tool) capable of illustrating the location of the DBS lead within the subject’s segmented anatomy as well as the volume of tissue activated (VTA) may have potential in the future to improve optimization and outcomes.
Method: A novel visualization software (GUIDE XT, Boston Scientific) was utilized in an ongoing prospective, multicenter, registry (NCT02071134). The registry utilizes pre-operative MRI and post-operative CT to identify the location of the DBS lead relative to the anatomical targets and to VTAs. The goal of the current study was to determine whether the tool when used by a clinician could shorten duration of initial programming. The time to reach effective DBS stimulation settings during the initial programming session was collected (pre-processing of images was not included).
Results: There were 44 patients to date and 39 had completed initial DBS programming and could be included in this study. Initial programming sessions (post-implant) using the visualization software were completed in 34.0 ± 28.8 minutes (mean +/- SD), and image-guided programming was completed in <30 minutes in 62% (24 of 39) of the cohort.
Conclusion: Preliminary results from this ongoing, open-label, prospective study utilizing a visualization tool suggested in general shorter initial programming sessions than reported for traditional trial-and-error approach (~140 minutes) (1). As a registry study, classically programmed control group or outcome comparisons were not included in the analysis, and time to pre-process images was not factored into the calculations. The move toward shorter, more efficient programming sessions could possibly improve access, satisfaction, and resource utilization.
References: 1. Pavese N, Tai VF, Yousif N, Nandi D, Bain PG. Traditional Trial and Error versus Neuroanatomic 3-Dimensional Image Software-Assisted Deep Brain Stimulation Programming in Patients with Parkinson Disease. World Neurosurg. 2020 Feb;134:e98-e102.
To cite this abstract in AMA style:
J. Aldred, T. Zesiewicz, M. Okun, J. Ramirez-Castaneda, L. Verhagen-Metman, C. Luca, R. Ramdhani, J. Durphy, Y. Bezchlibnyk, K. Foote, S. Sani, A. Papanastassiou, J. Carlson, J. Jagid, D. Weintraub, J. Piltitsis, Y. Pei, R. Jain. Programming Time and the Use of a Visualization Tool for DBS Programming of a Multiple-Source, Constant-Current System [abstract]. Mov Disord. 2022; 37 (suppl 2). https://www.mdsabstracts.org/abstract/programming-time-and-the-use-of-a-visualization-tool-for-dbs-programming-of-a-multiple-source-constant-current-system/. Accessed November 21, 2024.« Back to 2022 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/programming-time-and-the-use-of-a-visualization-tool-for-dbs-programming-of-a-multiple-source-constant-current-system/