Data di Pubblicazione:
2018
Citazione:
Eight-hours adaptive deep brain stimulation in patients with Parkinson disease / M. Arlotti, S. Marceglia, G. Foffani, J. Volkmann, A.M. Lozano, E. Moro, F. Cogiamanian, M. Prenassi, T. Bocci, F. Cortese, P. Rampini, S. Barbieri, A. Priori. - In: NEUROLOGY. - ISSN 0028-3878. - 90:11(2018 Mar 13), pp. e971-e976. [10.1212/WNL.0000000000005121]
Abstract:
OBJECTIVES:
To assess the feasibility and clinical efficacy of local field potentials (LFPs)-based adaptive deep brain stimulation (aDBS) in patients with advanced Parkinson disease (PD) during daily activities in an open-label, nonblinded study.
METHODS:
We monitored neurophysiologic and clinical fluctuations during 2 perioperative experimental sessions lasting for up to 8 hours. On the first day, the patient took his/her daily medication, while on the second, he/she additionally underwent subthalamic nucleus aDBS driven by LFPs beta band power.
RESULTS:
The beta band power correlated in both experimental sessions with the patient's clinical state (Pearson correlation coefficient r = 0.506, p < 0.001, and r = 0.477, p < 0.001). aDBS after LFP changes was effective (30% improvement without medication [3-way analysis of variance, interaction day × medication p = 0.036; 30.5 ± 3.4 vs 22.2 ± 3.3, p = 0.003]), safe, and well tolerated in patients performing regular daily activities and taking additional dopaminergic medication. aDBS was able to decrease DBS amplitude during motor "on" states compared to "off" states (paired t test p = 0.046), and this automatic adjustment of STN-DBS prevented dyskinesias.
CONCLUSIONS:
The main findings of our study are that aDBS is technically feasible in everyday life and provides a safe, well-tolerated, and effective treatment method for the management of clinical fluctuations.
CLASSIFICATION OF EVIDENCE:
This study provides Class IV evidence that for patients with advanced PD, aDBS is safe, well tolerated, and effective in controlling PD motor symptoms.
Tipologia IRIS:
01 - Articolo su periodico
Elenco autori:
M. Arlotti, S. Marceglia, G. Foffani, J. Volkmann, A.M. Lozano, E. Moro, F.M. Cogiamanian, M. Prenassi, T. Bocci, F. Cortese, P. Rampini, S. Barbieri, A. Priori
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