ArticleNeurology and therapy2022
Long-Term Clinical Experience with Directional Deep Brain Stimulation Programming: A Retrospective Review.
Article in Neurology and therapy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Stimulation settings in subthalamic nucleus deep brain stimulation for parkinson's disease - a retrospective single-center observational study.Neurological research and practice · 2026Article
- A bioelectric router for adaptive isochronous neurostimulation enables multipolar bioelectric stimulation from a single source.Scientific reports · 2025Article
- Directional Deep Brain Stimulation Programming: Is the Segment Clearly Identifiable and Stable Over Time?Movement disorders clinical practice · 2024Article
- Directional deep brain stimulation in the management of Parkinson's disease: efficacy and constraints-an analytical appraisal.Neurosurgical review · 2024Review
- Directional electrodes in deep brain stimulation: Results of a survey by the European Association of Neurosurgical Societies (EANS).Brain & spine · 2024Article
- Single-center experience of utilization and clinical efficacy of segmented leads for subthalamic deep brain stimulation in Parkinson's disease.Clinical parkinsonism & related disorders · 2024Article
- Minimising the rate of vascular complications in Deep Brain Stimulation surgery for the management of Parkinson's disease: a single-centre 600-patient case series.BMJ neurology open · 2024Article
- The role of neurotransmitter systems in mediating deep brain stimulation effects in Parkinson's disease.Frontiers in neuroscience · 2022Review
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionDirectional deep brain stimulation (d-DBS) axially displaces the volume of tissue activated (VTA) towards the intended target and away from neighboring structures potentially improving benefit and reducing side effects (SE) of stimulation. A clinical trial evaluating d-DBS demonstrated a wider therapeutic window (TW) with directional electrodes. While this seems advantageous, it remains unclear when and why directional stimulation is chosen clinically. To evaluate the implementation of d-DBS in our practice we examined the prevalence of and motivation for directional programming.
methodsA retrospective review was completed in consecutive patients with Parkinson's disease (PD)/essential tremor (ET) implanted with the Abbott Infinity system from December 2016 to January 2020. At 3, 12, 24, and 36 months we extracted post-DBS stimulation parameters; use of directional electrodes and other advanced programming techniques; and reasons for directional programming.
resultsFifty-six patients with PD and 18 patients with ET (104 and 33 leads, respectively) were identified. The numbers of patients programmed with a directional electrode in at least one DBS lead in PD and ET, respectively, were 22/56 (39%) and 13/18 (72%) at 3 months; 19/48 (40%) and 8/12 (67%) at 12 months; 12/31 (39%) and 5/8 (63%) at 24 months; and 6/9 (67%) and 1/2 (50%) at 36 months. In PD and ET, reasons for using directional stimulation were better symptom control, less SE, or combination of better symptom control/SE; additional reasons in ET were improved battery/TW%.
conclusionOver a 36-month time period 39-68% of patients with PD and 50-72% of patients with ET had at least one lead programmed directionally in order to either improve symptom control or reduce side effects, an option not available with conventional omnidirectional stimulation. Initially directional electrodes were used in ET more frequently than PD, likely because of the less complex nature of programming for a monosymptomatic disorder. However, over time this shifted as we gained directional experience and sought solutions to reduce worsening symptoms.
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