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Tinkhauser G, Pollo C, Debove I, Nowacki A, Krack P. Should asleep deep brain stimulation in Parkinson's disease be preferred over the awake approach? Pros. Swiss Med Wkly 2024; 154:3823. [PMID: 39137442 DOI: 10.57187/s.3823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2024] Open
Abstract
No abstract available.
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Affiliation(s)
- Gerd Tinkhauser
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Claudio Pollo
- Department of Neurosurgery, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Ines Debove
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Andreas Nowacki
- Department of Neurosurgery, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Paul Krack
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
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Büchele F, Stieglitz L, Baumann CR. Should asleep deep brain stimulation in Parkinson's disease be preferred over the awake approach? - Cons. Swiss Med Wkly 2024; 154:3855. [PMID: 39137444 DOI: 10.57187/s.3855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2024] Open
Abstract
No abstract available.
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Affiliation(s)
- Fabian Büchele
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | - Lennart Stieglitz
- Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland
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Krauss P, Duarte-Batista P, Hart M, Avecillas-Chasin J, Bercu M, Hvingelby V, Massey F, Ackermans L, Kubben P, van der Gaag N, Krüger M. Directional electrodes in deep brain stimulation: Results of a survey by the European Association of Neurosurgical Societies (EANS). BRAIN & SPINE 2024; 4:102756. [PMID: 38510592 PMCID: PMC10951785 DOI: 10.1016/j.bas.2024.102756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 01/05/2024] [Accepted: 01/21/2024] [Indexed: 03/22/2024]
Abstract
Introduction Directional Leads (dLeads) represent a new technical tool in Deep Brain Stimulation (DBS), and a rapidly growing population of patients receive dLeads. Research question The European Association of Neurosurgical Societies(EANS) functional neurosurgery Task Force on dLeads conducted a survey of DBS specialists in Europe to evaluate their use, applications, advantages, and disadvantages. Material and methods EANS functional neurosurgery and European Society for Stereotactic and Functional Neurosurgery (ESSFN) members were asked to complete an online survey with 50 multiple-choice and open questions on their use of dLeads in clinical practice. Results Forty-nine respondents from 16 countries participated in the survey (n = 38 neurosurgeons, n = 8 neurologists, n = 3 DBS nurses). Five had not used dLeads. All users reported that dLeads provided an advantage (n = 23 minor, n = 21 major). Most surgeons (n = 35) stated that trajectory planning does not differ when implanting dLeads or conventional leads. Most respondents selected dLeads for the ability to optimize stimulation parameters (n = 41). However, the majority (n = 24), regarded time-consuming programming as the main disadvantage of this technology. Innovations that were highly valued by most participants included full 3T MRI compatibility, remote programming, and closed loop technology. Discussion and conclusion Directional leads are widely used by European DBS specialists. Despite challenges with programming time, users report that dLeads have had a positive impact and maintain an optimistic view of future technological advances.
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Affiliation(s)
- P. Krauss
- Department of Neurosurgery, University Hospital Augsburg, Augsburg, Germany
| | - P. Duarte-Batista
- Neurosurgery Department, North Lisbon University Hospital Centre, Lisbon, Portugal
| | - M.G. Hart
- St George's, University of London & St George's University Hospitals NHS Foundation Trust, Institute of Molecular and Clinical Sciences, Neurosciences Research Centre, Cranmer Terrace, London, United Kingdom
| | - J.M. Avecillas-Chasin
- Department of Neurosurgery. University of Nebraska Medical Center. Omaha, Nebraska, USA
| | - M.M. Bercu
- Department of Pediatric Neurosurgery, Helen DeVos Children's Hospital, Corewell, USA
| | - V. Hvingelby
- Department of Clinical Medicine - Nuclear Medicine and PET Center, Aarhus University, Aarhus, Denmark
| | - F. Massey
- Unit of Neurosurgery, National Hospital of Neurology and Neurosurgery, London, United Kingdom
| | - L. Ackermans
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, the Netherlands
| | - P.L. Kubben
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, the Netherlands
| | - N.A. van der Gaag
- Department of Neurosurgery, Haga Teaching Hospital, The Hague, the Netherlands
- Department of Neurosurgery, Leiden University Medical Center, Leiden, the Netherlands
| | - M.T. Krüger
- Unit of Neurosurgery, National Hospital of Neurology and Neurosurgery, London, United Kingdom
- Department of Neurosurgery, University Medical Centre Freiburg, Germany
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Torres V, Del Giudice K, Roldán P, Rumià J, Muñoz E, Cámara A, Compta Y, Sánchez-Gómez A, Valldeoriola F. Image-guided programming deep brain stimulation improves clinical outcomes in patients with Parkinson's disease. NPJ Parkinsons Dis 2024; 10:29. [PMID: 38280901 PMCID: PMC10821897 DOI: 10.1038/s41531-024-00639-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 01/09/2024] [Indexed: 01/29/2024] Open
Abstract
Deep brain stimulation (DBS) is an effective treatment for patients with Parkinson's disease (PD). However, some patients may not respond optimally to clinical programming adjustments. Advances in DBS technology have led to more complex and time-consuming programming. Image-guided programming (IGP) could optimize and improve programming leading to better clinical outcomes in patients for whom DBS programming is not ideal due to sub-optimal response. We conducted a prospective single-center study including 31 PD patients with subthalamic nucleus (STN) DBS and suboptimal responses refractory to clinical programming. Programming settings were adjusted according to the volumetric reconstruction of the stimulation field using commercial postoperative imaging software. Clinical outcomes were assessed at baseline and at 3-month follow-up after IGP, using motor and quality of life (QoL) scales. Additionally, between these two assessment points, follow-up visits for fine-tuning amplitude intensity and medication were conducted at weeks 2, 4, 6, and 9. After IGP, twenty-six patients (83.9%) experienced motor and QoL improvements, with 25.8% feeling much better and 38.7% feeling moderately better according to the patient global impression scale. Five patients (16.1%) had no clinical or QoL changes after IGP. The MDS-UPDRS III motor scale showed a 21.9% improvement and the DBS-IS global score improved by 41.5%. IGP optimizes STN-DBS therapy for PD patients who are experiencing suboptimal clinical outcomes. These findings support using IGP as a standard tool in clinical practice, which could save programming time and improve patients' QoL.
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Affiliation(s)
- Viviana Torres
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut de Neurociencies, Hospital Clínic of Barcelona, Barcelona, Catalonia, Spain
| | - Kirsys Del Giudice
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut de Neurociencies, Hospital Clínic of Barcelona, Barcelona, Catalonia, Spain
| | - Pedro Roldán
- Neurosurgery Service, Institut de Neurociencies, Hospital Clínic of Barcelona, Barcelona, Catalonia, Spain
| | - Jordi Rumià
- Neurosurgery Service, Institut de Neurociencies, Hospital Clínic of Barcelona, Barcelona, Catalonia, Spain
| | - Esteban Muñoz
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut de Neurociencies, Hospital Clínic of Barcelona, Barcelona, Catalonia, Spain
| | - Ana Cámara
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut de Neurociencies, Hospital Clínic of Barcelona, Barcelona, Catalonia, Spain
| | - Yaroslau Compta
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut de Neurociencies, Hospital Clínic of Barcelona, Barcelona, Catalonia, Spain
| | - Almudena Sánchez-Gómez
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut de Neurociencies, Hospital Clínic of Barcelona, Barcelona, Catalonia, Spain.
| | - Francesc Valldeoriola
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut de Neurociencies, Hospital Clínic of Barcelona, Barcelona, Catalonia, Spain.
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