Objective: We describe utilization of newly available visualization software for use as a Deep Brain Stimulation (DBS) planning tool during initial programming of patients with Parkinson’s disease (PD) as part of an ongoing device registry.

Background: Optimization of DBS programming consists of a trial-and-error process involving appraisal of various stimulation parameters in which both clinician assessment and patient reporting of clinical benefit are required. However, this can be an inefficient and lengthy undertaking. The use of a visualization tool that illustrates location of the DBS lead in the patient’s own-segmented anatomy may help improve efficiency of achieving programming optimization and outcomes specific to the individual patient.

Method: This is a sub-study of ongoing prospective, multicenter, registry (NCT02071134) in which novel DBS visualization software (GUIDE XT, Boston Scientific) is utilized during initial device programming of patients implanted with a multiple-source, constant-current DBS System (Vercise, Boston Scientific).  The software uses pre-op MRI and post-op CT to create patient-specific anatomy enabling visualization based-programming and identification of the lead relative to anatomical targets.  The time duration to reach effective stimulation settings at the conclusion of initial programming (e.g.  monopolar review) using this visualization tool is collected and assessed. All participating patients must hold anti-parkinsonian medications overnight per standard of care (meds OFF).

Results: To date, 19 subjects have consented to participate in this ongoing sub-study where settings suggested by the novel visualization software provided a starting point for initial programming post-DBS implant.  Initial programming sessions (post-implant), where the visualization software was utilized to provide initial settings, lasted a mean 22.87 minutes (n = 8). Additional data to be presented.

Conclusion: Preliminary results suggest shorter initial programming sessions are possible using a visualization software tool compared to traditional trial-and-error approach as reported in the published literature. Shorter and more efficient programming sessions may lead to reduced programming visit time and improve resource utilization.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/visualization-tool-for-dbs-programming-with-a-multiple-source-constant-current-system-reduces-initial-programming-time/