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Ma Y, Miao S, Zhou R, Zhang Q, Chen H, Liang Y. Application of Remote Deep Brain Stimulation Programming for Parkinson's Disease Patients. World Neurosurg 2020; 147:e255-e261. [PMID: 33316487 DOI: 10.1016/j.wneu.2020.12.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/04/2020] [Accepted: 12/05/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Deep brain stimulation (DBS) is an important treatment for patients with advanced Parkinson's disease (PD). Patients after DBS implantation need specialized programming to get optimal outcomes. However, access to timely and economical postoperative programming for many patients living in remote areas is limited. Teleprogramming, which refers to deliver real-time remote programming through Internet, can help to address this gap. OBJECTIVE We aimed to evaluate the clinical application of remote programming for PD patients with DBS. METHODS We retrospectively studied 90 patients with PD who received remote DBS programming after implantation at Yuquan Hospital (Beijing, China) between March 2016 and June 2018. Patients' medical records were reviewed in an electronic database. A self-designed questionnaire was performed on all patients by phone. RESULTS Over a mean follow-up period of 27.0 months, 90 patients underwent a total of 386 remote programming visits, of which the average frequency within 6 months after DBS was 2.27 times/person. The average distance between the patients' residences and Yuquan Hospital was 1243.8 ± 746.5 km. The questionnaire survey showed that each remote programming visit saved ≥2000¥ for 76.7% of the patients and ≥12 hours for 90.0% of the patients, compared with the on-site programming visit. The acceptability of the remote programming platform was highly rated. Transient side effects related to programming were reported and were relieved after adjustments of parameters. CONCLUSIONS Remote programming may offer a feasible and acceptable approach to timely and economic management in patients with PD after DBS implantation.
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Affiliation(s)
- Yu Ma
- Neuromodulation Center, Yuquan Hospital, Tsinghua University, Beijing, China.
| | - Suhua Miao
- Neuromodulation Center, Yuquan Hospital, Tsinghua University, Beijing, China
| | - Rongsong Zhou
- Neuromodulation Center, Yuquan Hospital, Tsinghua University, Beijing, China
| | - Qi Zhang
- Beijing PINS Medical Co., Ltd., Beijing, China
| | - Hao Chen
- Beijing PINS Medical Co., Ltd., Beijing, China
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Development and Initial Validation of the Chinese Version of the Florida Surgical Questionnaire for Parkinson's Disease. PARKINSONS DISEASE 2020; 2020:8811435. [PMID: 33381295 PMCID: PMC7749765 DOI: 10.1155/2020/8811435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 11/19/2020] [Accepted: 11/27/2020] [Indexed: 11/17/2022]
Abstract
Background Deep brain stimulation (DBS) for Parkinson's disease (PD) has evolved as a well-established treatment in neurosurgery, and identifying appropriate surgical candidates could contribute to better DBS outcomes. The Florida Surgical Questionnaire for Parkinson Disease (FLASQ-PD) is a reasonable screening tool for assessing DBS candidacy in PD patients; however, a Chinese version of FLASQ-PD is needed for functional neurosurgery units in China. In this study, we translated the FLASQ-PD to Chinese and assessed its reliability and validity for Chinese PD patients. Methods The FLASQ-PD was translated before the study formally started. A single-center retrospective analysis of FLASQ-PD was performed at the Ruijin Hospital, affiliated with Shanghai Jiaotong University School of Medicine, between July and December 2019. The Unified Parkinson Disease Rating Scale III (UPDRS-III) was also used to assess PD patients on and off medication. All patients were evaluated for surgical candidacy by specialists. Results Overall, 115 PD patients, 25 with parkinsonism and six with multiple system atrophy were consecutively included. Internal consistency of the Chinese FLASQ-PD was roughly adequate (Cronbach's alpha = 0.664). There were significant differences in mean total scores of the Chinese FLASQ-PD between the diagnostic (Kruskal-Wallis H value = 37.450, p ≤ 0.001) and surgery-candidacy groups (H = 48.352, p ≤ 0.001). Drug improvements in UPDRS-III scores were mildly correlated with the Chinese FLASQ-PD scores in the surgery-ready group (Pearson correlation = 0.399, p=0.001). Conclusions The Chinese FLASQ-PD, which is a simple and efficient screening tool for clinicians, was developed and initially validated in this retrospective single-center study.
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Harmsen IE, Elias GJ, Beyn ME, Boutet A, Pancholi A, Germann J, Mansouri A, Lozano CS, Lozano AM. Clinical trials for deep brain stimulation: Current state of affairs. Brain Stimul 2020; 13:378-385. [DOI: 10.1016/j.brs.2019.11.008] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 11/07/2019] [Accepted: 11/17/2019] [Indexed: 12/20/2022] Open
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Wang T, Pan Y, Zhang C, Zhan S, Sun B, Li D. Lead fixation in deep brain stimulation: comparison of three lead anchoring devices in China. BMC Surg 2019; 19:92. [PMID: 31307448 PMCID: PMC6631761 DOI: 10.1186/s12893-019-0558-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 07/08/2019] [Indexed: 11/15/2022] Open
Abstract
Background The accuracy of deep brain stimulation (DBS) depends on precise electrode positioning, which has been pursued for ideal treatment outcomes. As a critical component of DBS, the fixation performance of lead anchoring devices has been widely studied. Possible reasons for lead shift were analyzed in the current study and we further provided effective solutions to reduce potential manual errors. Methods Seventy-nine patients who received DBS implantations at the Ruijin Hospital from April to November 2017 were retrospectively reviewed. Intraoperative lead shifts were measured by C-arm fluoroscopy. Lead adjustment counts were recorded and compared among three lead fixation devices: Stimloc™ (Medtronic, Minneapolis, MN, USA), TouchLoc (SceneRay, Suzhou, China), and the traditional lead anchoring device. Results Mean (± SD) distances of lead shifts were 0.29 ± 2.42 mm in Stimloc devices, 0.43 ± 0.55 mm in TouchLoc devices, and 1.52 ± 1.05 mm in traditional devices (p < 0.0001). Average numbers of adjustments in this series were 0.3 ± 0.5 in Stimloc devices, 0.3 ± 1.3 in TouchLoc devices, and 1.1 ± 1.0 in traditional devices (p = 0.0001). Pairwise comparisons among the three devices (TouchLoc vs. Stimloc: p = 0.273; TouchLoc vs. Traditional: p = 0.0001; Stimloc vs. traditional: p < 0.0001) suggested significant differences, which were mainly attributed to the traditional devices. Conclusions Three lead anchoring devices have been compared for their performance in the accuracy of lead fixation, in which the newly designed lead fixation devices have presented its advantages to the traditional one. In addition to the application of the Stimloc and TouchLoc devices, verification by C-arm fluoroscopy should be performed to provide an intuitive view of the depth deviation of electrode position during DBS electrode implantation.
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Affiliation(s)
- Tao Wang
- Department of Functional Neurosurgery, Ruijin Hospital affiliated to Shanghai Jiaotong University School of Medicine, No.197, Ruijin Second Road, Huangpu District, Shanghai, 200025, China
| | - Yixin Pan
- Department of Functional Neurosurgery, Ruijin Hospital affiliated to Shanghai Jiaotong University School of Medicine, No.197, Ruijin Second Road, Huangpu District, Shanghai, 200025, China
| | - Chencheng Zhang
- Department of Functional Neurosurgery, Ruijin Hospital affiliated to Shanghai Jiaotong University School of Medicine, No.197, Ruijin Second Road, Huangpu District, Shanghai, 200025, China
| | - Shikun Zhan
- Department of Functional Neurosurgery, Ruijin Hospital affiliated to Shanghai Jiaotong University School of Medicine, No.197, Ruijin Second Road, Huangpu District, Shanghai, 200025, China
| | - Bomin Sun
- Department of Functional Neurosurgery, Ruijin Hospital affiliated to Shanghai Jiaotong University School of Medicine, No.197, Ruijin Second Road, Huangpu District, Shanghai, 200025, China
| | - Dianyou Li
- Department of Functional Neurosurgery, Ruijin Hospital affiliated to Shanghai Jiaotong University School of Medicine, No.197, Ruijin Second Road, Huangpu District, Shanghai, 200025, China.
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Li D, Zhang C, Gault J, Wang W, Liu J, Shao M, Zhao Y, Zeljic K, Gao G, Sun B. Remotely Programmed Deep Brain Stimulation of the Bilateral Subthalamic Nucleus for the Treatment of Primary Parkinson Disease: A Randomized Controlled Trial Investigating the Safety and Efficacy of a Novel Deep Brain Stimulation System. Stereotact Funct Neurosurg 2017; 95:174-182. [DOI: 10.1159/000475765] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 04/05/2017] [Indexed: 11/19/2022]
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Shi L, Zhang CC, Li JJ, Zhu GY, Chen YC, Zhang JG. Could cough be an intraoperative indicator for venous air embolism in deep brain stimulation surgeries?: experiences from a large case series. Chin Neurosurg J 2016. [DOI: 10.1186/s41016-016-0048-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Deer TR, Krames E, Mekhail N, Pope J, Leong M, Stanton-Hicks M, Golovac S, Kapural L, Alo K, Anderson J, Foreman RD, Caraway D, Narouze S, Linderoth B, Buvanendran A, Feler C, Poree L, Lynch P, McJunkin T, Swing T, Staats P, Liem L, Williams K. The Appropriate Use of Neurostimulation: New and Evolving Neurostimulation Therapies and Applicable Treatment for Chronic Pain and Selected Disease States. Neuromodulation 2014; 17:599-615; discussion 615. [DOI: 10.1111/ner.12204] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 01/14/2014] [Accepted: 02/07/2014] [Indexed: 12/20/2022]
Affiliation(s)
| | | | - Nagy Mekhail
- University of Kentucky-Lexington; Lexington KY USA
| | - Jason Pope
- Center for Pain Relief; Charleston WV USA
| | | | | | | | - Leo Kapural
- Carolinas Pain Institute at Brookstown; Wake Forest Baptist Health; Winston-Salem NC USA
| | - Ken Alo
- The Methodist Hospital Research Institute; Houston TX USA
- Monterey Technical Institute; Monterey Mexico
| | | | - Robert D. Foreman
- University of Oklahoma Health Sciences Center, College of Medicine; Oklahoma City OK USA
| | - David Caraway
- Center for Pain Relief, Tri-State, LLC; Huntington WV USA
| | - Samer Narouze
- Anesthesiology and Pain Medicine, Neurological Surgery; Summa Western Reserve Hospital; Cuyahoga Falls OH USA
| | - Bengt Linderoth
- Functional Neurosurgery and Applied Neuroscience Research Unit, Karolinska Institute; Karolinska University Hospital; Stockholm Sweden
| | | | - Claudio Feler
- University of Tennessee; Memphis TN USA
- Valley View Hospital; Glenwood Springs CO USA
| | - Lawrence Poree
- University of California at San Francisco; San Francisco CA USA
- Pain Clinic of Monterey Bay; Aptos CA
| | - Paul Lynch
- Arizona Pain Specialists; Scottsdale AZ USA
| | | | - Ted Swing
- Arizona Pain Specialists; Scottsdale AZ USA
| | - Peter Staats
- Premier Pain Management Centers; Shrewsbury NJ USA
- Johns Hopkins University; Baltimore MD USA
| | - Liong Liem
- St. Antonius Hospital; Nieuwegein The Netherlands
| | - Kayode Williams
- Johns Hopkins School of Medicine and Carey Business School; Baltimore MD USA
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Johansson V, Garwicz M, Kanje M, Halldenius L, Schouenborg J. Thinking Ahead on Deep Brain Stimulation: An Analysis of the Ethical Implications of a Developing Technology. AJOB Neurosci 2014; 5:24-33. [PMID: 24587963 PMCID: PMC3933012 DOI: 10.1080/21507740.2013.863243] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Deep brain stimulation (DBS) is a developing technology. New generations of DBS technology are already in the pipeline, yet this particular fact has been largely ignored among ethicists interested in DBS. Focusing only on ethical concerns raised by the current DBS technology is, albeit necessary, not sufficient. Since current bioethical concerns raised by a specific technology could be quite different from the concerns it will raise a couple of years ahead, an ethical analysis should be sensitive to such alterations, or it could end up with results that soon become dated. The goal of this analysis is to address these changing bioethical concerns, to think ahead on upcoming and future DBS concerns both in terms of a changing technology and changing moral attitudes. By employing the distinction between inherent and noninherent bioethical concerns we identify and make explicit the particular limits and potentials for change within each category, respectively, including how present and upcoming bioethical concerns regarding DBS emerge and become obsolete. Many of the currently identified ethical problems with DBS, such as stimulation-induced mania, are a result of suboptimal technology. These challenges could be addressed by technical advances, while for instance perceptions of an altered body image caused by the mere awareness of having an implant may not. Other concerns will not emerge until the technology has become sophisticated enough for new uses to be realized, such as concerns on DBS for enhancement purposes. As a part of the present analysis, concerns regarding authenticity are used as an example.
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Liu HG, Ma Y, Zhang K, Ge M, Meng FG, Feng T, Wan XH, Guo Y, Wang RZ, Yang AC, Hu WH, Guo JZ, Zhang JG. Subthalamic Deep Brain Stimulation With a New Device in Parkinson's Disease: An Open-Label Trial. Neuromodulation 2013; 16:212-8; discussion 218. [DOI: 10.1111/ner.12050] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 01/14/2013] [Accepted: 02/07/2013] [Indexed: 11/26/2022]
Affiliation(s)
- Huan-guang Liu
- Department of Neurology and Neurosurgery; Beijing Tiantan Hospital; Capital Medical University; Beijing; China
| | - Yu Ma
- Beijing Neurosurgical Institute; Capital Medical University; Beijing; China
| | - Kai Zhang
- Department of Neurology and Neurosurgery; Beijing Tiantan Hospital; Capital Medical University; Beijing; China
| | - Ming Ge
- Department of Neurology and Neurosurgery; Beijing Tiantan Hospital; Capital Medical University; Beijing; China
| | - Fan-gang Meng
- Beijing Neurosurgical Institute; Capital Medical University; Beijing; China
| | - Tao Feng
- Department of Neurology and Neurosurgery; Beijing Tiantan Hospital; Capital Medical University; Beijing; China
| | - Xin-hua Wan
- Peking Union Medical College Hospital; Beijing; China
| | - Yi Guo
- Peking Union Medical College Hospital; Beijing; China
| | - Ren-zhi Wang
- Peking Union Medical College Hospital; Beijing; China
| | - An-chao Yang
- Department of Neurology and Neurosurgery; Beijing Tiantan Hospital; Capital Medical University; Beijing; China
| | - Wen-han Hu
- Beijing Neurosurgical Institute; Capital Medical University; Beijing; China
| | - Jin-zu Guo
- Peking Union Medical College Hospital; Beijing; China
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