Adaptive Deep Brain Stimulation for Parkinson’s disease: Safety and effectiveness

Publication date: January 2019

Source: Clinical Neurophysiology, Volume 130, Issue 1

Author(s): T. Bocci, M. Arlotti, S. Marceglia, M. Prenassi, G. Ardolino, F. Cogiamanian, L. Borrellini, P. Rampini, M. Locatelli, S. Barbieri, A. Priori

Deep Brain Stimulation (DBS) is an effective therapy for Parkinson's disease (PD). We assessed the effectiveness of adaptive DBS (aDBS), that uses beta-band power of the subthalamic Local Field Potentials (LFPs) as target to adapt DBS parameters to motor fluctuations. In a first experiment, aDBS plus levodopa versus levodopa alone was studied; in a second phase, we evaluated aDBS versus cDBS. The experiments took place 5 days after implantation and lasted 2 days (Day 5 and 6, eight hours per day). Changes in the Unified Parkinson's Disease Rating Scale (UPDRSIII) and Rush Dyskinesia Rating Scale were assessed. In the first experiment, in Day 5 DBS was turned OFF, while in Day 6 aDBS stimulation was turned on. In the second, cDBS was turned ON during Day 5 and aDBS turned ON during Day 6. aDBS improved UPDRSIII score compared to levodopa (three-way ANOVA, "day"x"medication" p = 0.003). Rush-DRS score from baseline was lower in aDBS patients than in cDBS (Wilcoxon-Mann-Whitney test: p < 0.005), although UPDRSIII was comparable (UPDRSIII mean variation, Day 5: 55.69 ± 5.16%; Day 6: 42.66 ± 4.14%).

aDBS was effective in controlling the patients PD symptoms in addition to the normal Levodopa therapy, reducing dyskinesias compared to cDBS.

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