Abstract Details

Title Clinical Outcomes from Directional Deep Brain Stimulation in Parkinson's Disease Patients: A Retrospective Analysis

Topic Movement Disorders

Presentation(s) P1 - Poster Session 1 (12:00 PM-1:00 PM)

Poster/Presentation
Number 3-006

Objective

To compare clinical outcome measures before and after deep brain stimulation (DBS) in Parkinson's disease patients using segmented leads.

Background

DBS of the subthalamic nucleus (STN) and the internal globus pallidus (GPi) effectively improves motor symptoms in appropriately selected patients with advanced PD. Segmented leads are a relatively recent procedural innovation that allow for current steering towards the intended target and away from brain areas that may produce side effects.

Design/Methods

We performed a retrospective chart review on PD patients who underwent DBS directional lead placement (Boston Scientific Vercise System: Cartesia leads and Gevia generators) from February 2019 through September 2019. Clinical outcomes included pre- surgical Unified Parkinson's Disease Rating Scale (UPDRS) part III motor scores obtained in medication OFF states, post-surgical UPDRS part III motor scores obtained in the stimulation ON/medication ON (ON/ON) state, and changes in levodopa equivalent daily dose (LEDD).

Results The data from 18 patients was analyzed (7 patients implanted unilaterally; 11 bilaterally; 8 patients implanted in the STN, 10 patients in the GPi; mean age 60.6 ± 12.8 years, disease duration 8.2 ± 3.8 years, mean follow up 2.3± 1.9 months). There were reductions in LEDD in the entire cohort following DBS (1008.9 ± 670.5 mg to 750.7± 642.8, 21.8% reduction, p = 0.08). Post-operative ON/ON UPDRS motor scores compared to baseline OFF motor scores were significantly improved (mean improvement 67% p < 0.0001) using one-sample Wilcoxin signed rank test. Side effects included mild tethering of the extension wires in two patients which has not required surgical revision to date.

Conclusions

Current steering with segmented DBS leads resulted in significant improvements in UPDRS motor scores (baseline OFF compared to Post Operative ON/ON) with few side effects. Further long-term follow-up is needed to assess the effect of directionality in patients receiving DBS.

Authors/Disclosures
Alina Shub, PA (University of South Florida) PRESENTER	The institution of Ms. Shub has received research support from Abbott and Boston Scientific .
Yarema Bezchlibnyk	Yarema Bezchlibnyk has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Medtronic. Yarema Bezchlibnyk has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for PMT Inc. Yarema Bezchlibnyk has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Abbott. Yarema Bezchlibnyk has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Boston Scientific. Yarema Bezchlibnyk has received research support from Medtronic.
Donald P. Smith	No disclosure on file
	No disclosure on file
Wai Wai Miller, MD	No disclosure on file
	No disclosure on file
Stephen Aradi, MD (University of South FLorida)	Dr. Aradi has nothing to disclose.
Theresa A. Zesiewicz, MD (University of South Florida)	Dr. Zesiewicz has received personal compensation for serving as an employee of Medscape. Dr. Zesiewicz has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Lexeo. Dr. Zesiewicz has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Steminent. Dr. Zesiewicz has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Larimar. Dr. Zesiewicz has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biohaven. Dr. Zesiewicz has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Zesiewicz has received intellectual property interests from a discovery or technology relating to health care. Dr. Zesiewicz has received intellectual property interests from a discovery or technology relating to health care. Dr. Zesiewicz has received intellectual property interests from a discovery or technology relating to health care.