Log In

Forgot Password?
Create New Account

Loading... please wait

Abstract Details

Assessment of lmage-guided Programming (IGP) on Bilateral STN and GPi Deep Brain Stimulation Programming Time
Movement Disorders
P1 - Poster Session 1 (8:00 AM-9:00 AM)
3-003

Optimization of DBS programming can be a lengthy, empirical trial-and-error process potentially leading to extended programming sessions and frequent visits. An IGP-based platform can help visualize lead location relative to anatomy with capability of reducing programming times and aiding active contact(s) selection through direct visualization and targeting of Stimulation Field Models (SFMs).

Assessment of Parkinson's disease (PD) patient outcomes using an image-guided programming (IGP) applied during initial deep brain stimulation (DBS) programming, either with STN or GPi as brain target.

Novel IGP software (GUIDE XT, Boston Scientific) was evaluated from an ongoing prospective, multicenter, registry (NCT02071134) in which preoperative MRI and post-operative CT scans were provided to localize the DBS lead relative to each subject's anatomy and to select programming parameters per alignment with SFMs. Time to reach effective DBS settings during the initial programming session was collected, along with device-aided suggested stimulation settings.

To date, 57-subjects (mean age 62.9-years, 77% male) with 10.1-years of disease duration have been enrolled. Initial programming sessions (post-implant), where IGP provided settings for directional leads, lasted 39.4±4.4 minutes (mean ± SE). Fifty-five percent (31/56) completed initial programming of bilateral directional leads with the IGP in <30-minutes. Motor function (mean MDS­UPDRS Ill scores [Meds OFF]) was significantly improved by 55% (n=45) and 45% (n=37) at 6-and 12-months, respectively. Of 21 patients for whom follow-up programming information out to 6- and 12-months was available, 52% and 43% of DBS programs remained unchanged from initial setting (i.e., no change in active contact(s) and cathodic/anodic distribution of current), respectively, as suggested by IGP.

These results indicate that use of this tool is associated with rapid initial programming sessions and clinically significant motor improvement. Though optimization was subjective in this evaluation, and there was no control group, this tool revealed promising time-based and motor outcomes.

Authors/Disclosures
Jason L. Aldred, MD, FAAN (Selkirk Neurology)
PRESENTER
Dr. Aldred has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Medtronic. Dr. Aldred has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Boston Scientific. Dr. Aldred has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Abbvie. Dr. Aldred has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen . Dr. Aldred has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Allergan . Dr. Aldred has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Quadralynx. Dr. Aldred has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbvie. Dr. Aldred has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Boston Scientific. Dr. Aldred has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medtronic. Dr. Aldred has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Abbvie. Dr. Aldred has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Acorda. Dr. Aldred has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Adamas. Dr. Aldred has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Allergan. Dr. Aldred has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Boston Scientific. Dr. Aldred has received personal compensation in the range of $100,000-$499,999 for serving on a Speakers Bureau for TEVA. Dr. Aldred has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Medtronic. Dr. Aldred has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for US World Meds. Dr. Aldred has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Kyowa Kirin. Dr. Aldred has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Sunovion. Dr. Aldred has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Amneal. Dr. Aldred has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Dr. Aldred has received personal compensation in the range of $100,000-$499,999 for serving as an Expert Witness for Arete Neuroscience, PLLC. The institution of Dr. Aldred has received research support from Biogen . The institution of Dr. Aldred has received research support from Abbvie. The institution of Dr. Aldred has received research support from Atara. The institution of Dr. Aldred has received research support from Takeda. The institution of Dr. Aldred has received research support from Merz. The institution of Dr. Aldred has received research support from AstraZeneca. The institution of Dr. Aldred has received research support from Neurocrine. The institution of Dr. Aldred has received research support from Aptinyx. The institution of Dr. Aldred has received research support from Cerevance. The institution of Dr. Aldred has received research support from Boston Scientific . The institution of Dr. Aldred has received research support from Parkinson Foundation . The institution of Dr. Aldred has received research support from Roche. The institution of Dr. Aldred has received research support from Theravance. The institution of Dr. Aldred has received research support from Triplet Therapeutics. The institution of Dr. Aldred has received research support from UCB. The institution of Dr. Aldred has received research support from Cerevel . The institution of Dr. Aldred has received research support from Sage Therapeutics. The institution of Dr. Aldred has received research support from Annovis. The institution of Dr. Aldred has received research support from Biovie. The institution of Dr. Aldred has received research support from Athira. The institution of Dr. Aldred has received research support from IRL. The institution of Dr. Aldred has received research support from NeuroDerm.
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 intellectual property interests from a discovery or technology relating to health care.
Michael S. Okun, MD, FAAN (University of Florida) Dr. Okun has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NIH. Dr. Okun has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Parkinson's Foundation. Dr. Okun has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA Neurology. Dr. Okun has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for NEJM Journal Watch. The institution of Dr. Okun has received research support from NIH. The institution of Dr. Okun has received research support from Parkinson's Foundation. The institution of Dr. Okun has received research support from Tourette Association of America. The institution of Dr. Okun has received research support from Michael J Fox. Dr. Okun has received publishing royalties from a publication relating to health care.
Juan Ramirez Castaneda, MD (Methodist Physicians. Neurosurgery and Neurology Specialists) Dr. Ramirez Castaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbott. Dr. Ramirez Castaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie . Dr. Ramirez Castaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amneal. Dr. Ramirez Castaneda has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Supernus. Dr. Ramirez Castaneda has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Abbvie .
Leonard Verhagen Metman, MD, PhD (Northwestern University) Dr. Verhagen Metman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for AbbVie. Dr. Verhagen Metman has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Abbott. Dr. Verhagen Metman has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Mitsubishi Tanabe. Dr. Verhagen Metman has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Supernus. Dr. Verhagen Metman has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AbbVie. Dr. Verhagen Metman has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cerevel. Dr. Verhagen Metman has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Frontiers.
Corneliu C. Luca, MD (University of Miami) Dr. Luca has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Boston Scientific. Dr. Luca has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Signant Health.
Ritesh Ramdhani, MD (Northwell Health) Dr. Ramdhani has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Accorda. Dr. Ramdhani has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amneal. The institution of Dr. Ramdhani has received research support from NIH. Dr. Ramdhani has received research support from Parkinson Alliance.
Jennifer L. Durphy, MD (Albany Medical Center) Dr. Durphy has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Acorda.
Yarema Bezchlibnyk No disclosure on file
Jonathan Carlson No disclosure on file
Kelly D. Foote, MD Kelly D. Foote, MD has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Axio/Neurocrine Biosciences.
Sepehr Sani No disclosure on file
Alexander M. Papanastassiou Alexander M. Papanastassiou has received intellectual property interests from a discovery or technology relating to health care.
Jonathan Jagid No disclosure on file
David Weintraub (Nassau University Medical Center) No disclosure on file
Julie Pilitsis No disclosure on file
Ben Reese (Boston Scientific) No disclosure on file
Lilly Chen (Boston Scientific) No disclosure on file
Rajat Shivacharan (Boston Scientific) No disclosure on file
Edward Goldberg (Boston Scientific) No disclosure on file