Objective: Consider a stimulation programming method that can be performed easily and in a short time.

Background: Background: Since the subthalamic nucleus (STN) is a small structure, STN-DBS currents may spread to the surrounding structures and cause stimulation evoked adverse events. Nowadays, Implantable Pulse Generators (IPG) which is capable of constant current setting (MICC technology) for each stimulus point and Directional Lead (DL) which is capable of adjusting the spread of the currents in the horizontal direction were launched. It is expected that the stimulus setting range will be expanded, and the effect of the STN DBS will be enhanced, on the other hand programming become complicated. We examined whether simple programming methods are effective for STN-DBS cases using these devices.

Methods: Method: In this study, we include twelve PD patients receiving STN-DBS with Boston Scientific Vercise PC IPG, and Cartesia Directional Lead. Average age and off time UPDRS part III score was 62.1 +/- 5.7 and 41.0+/-23.6.1. We divided into two groups. In the first group (A group), each contact was screened in Ring (R) mode. We examined the current value which is sufficient for motor symptom improvement and the current value which capsular response was appeared. According to these results, the optimal contact was decided, and stimulation was set by comparing the effects of R mode and Directional (D) mode were compared. The second group (B Group) was screened at a constant current setting of 1.5 mA. We searched for the optimal stimulation level while continuously stimulating each contact from the bottom to the top. The effect of R mode and D mode were compared in the determined level, and stimulation settings was programmed with most effective way. We examined which programming method is useful by evaluating screening time, stimulation effect for motor control after 12 weeks, number of setting change in these two groups.

Results: There were six cases in each group. Both 75% of electrodes of each groups were setting in D mode stimulation. The stimulation effect for motor control by UPDRS part III was -66.7+/-20.6% in A Group and -64.6+/-19.5% in B Group. It was almost equal. The screening time was 2.44+/-1.22 hours in A Group and 17.0+/-8.4 minutes in B Group. In group B, the screening time was shorter, and the burden on the patient was small.

Conclusions: Group B setting method was efficient and no-burden methods for the patients with STN-DBS using directional leads.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/simple-programming-method-in-stn-dbs-using-directional-lead/