Imaging-Guided Subthalamic Nucleus Deep Brain Stimulation Programming for Parkinson Disease: A Real-Life Pilot Study.

IF 2.3 Q3 CLINICAL NEUROLOGY

Neurology. Clinical practice Pub Date : 2024-12-01 Epub Date: 2024-09-11 DOI:10.1212/CPJ.0000000000200326

Mickael Aubignat, Alexis Berro, Mélissa Tir, Michel Lefranc

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引用次数: 0

Abstract

Background and objectives: Deep brain stimulation (DBS) is a well-established treatment for Parkinson disease (PD), with programming methods continually evolving. This study aimed to compare the efficacy and patient burden between conventional ring-mode programming (CP-RM) and image-guided volume of tissue activated (IG-VTA) programming for subthalamic nucleus (STN) DBS in PD.

Methods: In this retrospective study, patients with PD who underwent STN-DBS between 2011 and 2014 (CP-RM group) and 2019 and 2021 (IG-VTA group) were evaluated. The primary outcome was the improvement in the UPDRS III score from preoperative OFF to postoperative ON state without medication at one-year follow-up. Secondary outcomes included hospital stay duration and programming sessions.

Results: A total of 26 patients were analyzed (IG-VTA: n = 12, CP-RM: n = 14). Both groups showed similar improvements in UPDRS III scores (IG-VTA: 43.62, CP-RM: 41.29). However, the IG-VTA group experienced shorter immediate postoperative hospital stays and fewer hospitalizations after discharge.

Discussion: IG-VTA programming preserved the clinical efficacy of STN-DBS over 1 year and reduced the patient and clinician burden of hospital stay and programming sessions. However, conclusions drawn must consider the limitations of retrospective design, differing time epochs, and evolving clinical practices. Further multicentric and prospective studies are warranted to validate these findings in the evolving field of neurostimulation.

Trial registration information: The trial is registered on clinicaltrials.gov (NCT05103072).

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影像引导下的眼下核深部脑刺激编程治疗帕金森病：真实生活试点研究

背景和目的：脑深部刺激（DBS）是治疗帕金森病（PD）的一种行之有效的方法，其编程方法也在不断发展。本研究旨在比较传统环形模式编程（CP-RM）和图像引导组织激活体积编程（IG-VTA）在眼下核（STN）DBS 治疗帕金森病中的疗效和患者负担：在这项回顾性研究中，对 2011 年至 2014 年（CP-RM 组）和 2019 年至 2021 年（IG-VTA 组）期间接受 STN-DBS 治疗的 PD 患者进行了评估。主要结果是随访一年时，UPDRS III评分从术前的 "关 "状态改善到术后的 "开 "状态，且无需服药。次要结果包括住院时间和编程次数：共分析了 26 名患者（IG-VTA：n = 12，CP-RM：n = 14）。两组患者的 UPDRS III 评分改善情况相似（IG-VTA：43.62，CP-RM：41.29）。然而，IG-VTA 组术后住院时间更短，出院后住院次数更少：讨论：IG-VTA 编程保留了 STN-DBS 1 年的临床疗效，并减轻了患者和临床医生住院和编程疗程的负担。然而，得出的结论必须考虑到回顾性设计、不同时间段和不断变化的临床实践的局限性。有必要进一步开展多中心和前瞻性研究，以便在不断发展的神经刺激领域验证这些发现：该试验已在 clinicaltrials.gov (NCT05103072) 上注册。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurology. Clinical practice CLINICAL NEUROLOGY-

CiteScore

4.00

自引率

0.00%

发文量

期刊介绍： Neurology® Genetics is an online open access journal publishing peer-reviewed reports in the field of neurogenetics. The journal publishes original articles in all areas of neurogenetics including rare and common genetic variations, genotype-phenotype correlations, outlier phenotypes as a result of mutations in known disease genes, and genetic variations with a putative link to diseases. Articles include studies reporting on genetic disease risk, pharmacogenomics, and results of gene-based clinical trials (viral, ASO, etc.). Genetically engineered model systems are not a primary focus of Neurology® Genetics, but studies using model systems for treatment trials, including well-powered studies reporting negative results, are welcome.