Thompson JA, Hirt L, David‐Gerecht P, Fasano A, Kramer DR, Ojemann SG, Kern DS. Comparison of Monopolar Review to Fixed Parameter Fractionation in Deep Brain Stimulation.
Mov Disord Clin Pract 2023;
10:987-991. [PMID:
37332654 PMCID:
PMC10272899 DOI:
10.1002/mdc3.13750]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/21/2023] [Accepted: 03/29/2023] [Indexed: 06/20/2023] Open
Abstract
Background
Technological advancements in deep brain stimulation (DBS) require methodological changes in programming. Fractionalization poses significant practical challenges for the most common approach for assessing DBS efficacy, monopolar review (MR).
Objectives
Two DBS programming methods: MR and fixed parameter vertical and horizontal fractionalization (FPF) were compared.
Methods
A two-phase process of vertical and horizontal FPF was performed. MR was conducted thereafter. After a short wash-out period, both optimal configurations determined by MR and FPF were tested in a double-blind randomized manner.
Results
Seven PD patients were enrolled, providing 11 hemispheres to compare the two conditions. In all subjects, the blinded examiner selected a directional or fractionalization configuration. There was no significant difference in clinical benefits between MR and FPF. FPF was the preferred method for initial programming as selected by subject and clinician.
Conclusions
FPF programming is a viable and efficient methodology that may be incorporated into clinical practice.
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