Open AccessComputer‐Guided Deep Brain Stimulation Programming for P arkinson's Disease
Author(s) -
Heldman Dustin A.,
Pulliam Christopher L.,
Urrea Mendoza Enrique,
Gartner Maureen,
Giuffrida Joseph P.,
Montgomery Erwin B.,
Espay Alberto J.,
Revilla Fredy J.
Publication year - 2016
Publication title -
neuromodulation: technology at the neural interface
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.296
H-Index - 60
eISSN - 1525-1403
pISSN - 1094-7159
DOI - 10.1111/ner.12372
Subject(s) - deep brain stimulation , parkinson's disease , physical medicine and rehabilitation , motion sensors , software , computer science , essential tremor , medicine , simulation , physical therapy , disease , artificial intelligence , pathology , programming language
Objective Pilot study to evaluate computer‐guided deep brain stimulation ( DBS ) programming designed to optimize stimulation settings using objective motion sensor‐based motor assessments. Materials and Methods Seven subjects (five males; 54–71 years) with P arkinson's disease ( PD ) and recently implanted DBS systems participated in this pilot study. Within two months of lead implantation, the subject returned to the clinic to undergo computer‐guided programming and parameter selection. A motion sensor was placed on the index finger of the more affected hand. Software guided a monopolar survey during which monopolar stimulation on each contact was iteratively increased followed by an automated assessment of tremor and bradykinesia. After completing assessments at each setting, a software algorithm determined stimulation settings designed to minimize symptom severities, side effects, and battery usage. Results Optimal DBS settings were chosen based on average severity of motor symptoms measured by the motion sensor. Settings chosen by the software algorithm identified a therapeutic window and improved tremor and bradykinesia by an average of 35.7% compared with baseline in the “off” state ( p < 0.01). Conclusions Motion sensor‐based computer‐guided DBS programming identified stimulation parameters that significantly improved tremor and bradykinesia with minimal clinician involvement. Automated motion sensor‐based mapping is worthy of further investigation and may one day serve to extend programming to populations without access to specialized DBS centers.