Eight-hours conventional versus adaptive deep brain stimulation of the subthalamic nucleus in Parkinson's disease

Tommaso Bocci; Marco Prenassi; Mattia Arlotti; Filippo Maria Cogiamanian; Linda Borellini; Elena Moro; Andres M Lozano; Jens Volkmann; Sergio Barbieri; Alberto Priori; Sara Marceglia

doi:10.1038/s41531-021-00229-z

Eight-hours conventional versus adaptive deep brain stimulation of the subthalamic nucleus in Parkinson's disease

NPJ Parkinsons Dis. 2021 Sep 28;7(1):88. doi: 10.1038/s41531-021-00229-z.

Authors

Tommaso Bocci^#^{1

2}, Marco Prenassi^#³, Mattia Arlotti⁴, Filippo Maria Cogiamanian⁵, Linda Borellini⁵, Elena Moro⁶, Andres M Lozano⁷, Jens Volkmann⁸, Sergio Barbieri⁵, Alberto Priori^{9

10}, Sara Marceglia^{3

5}

Affiliations

¹ "Aldo Ravelli" Research Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan Medical School, Milan, Italy.
² III Neurology Clinic, ASST Santi Paolo e Carlo, Milan, Italy.
³ Dipartimento in Ingegneria e Architettura, Università degli studi di Trieste, Trieste, Italy.
⁴ Newronika S.p.A., Milan, Italy.
⁵ U.O. Fisiopatologia,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
⁶ Division of Neurology, Centre Hospitalier Universitaire de Grenoble, Grenoble, France.
⁷ Division of Neurosurgery, University of Toronto, Toronto, ON, Canada.
⁸ Department of Neurology, University of Wurzburg, Würzburg, Germany.
⁹ "Aldo Ravelli" Research Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan Medical School, Milan, Italy. Alberto.priori@unimi.it.
¹⁰ III Neurology Clinic, ASST Santi Paolo e Carlo, Milan, Italy. Alberto.priori@unimi.it.

^# Contributed equally.

Abstract

This study compares the effects on motor symptoms between conventional deep brain stimulation (cDBS) and closed-loop adaptive deep brain stimulation (aDBS) in patients with Parkinson's Disease. The aDBS stimulation is controlled by the power in the beta band (12-35 Hz) of local field potentials recorded directly by subthalamic nucleus electrodes. Eight subjects were assessed in two 8-h stimulation sessions (first day, cDBS; second day, aDBS) with regular levodopa intake and during normal daily activities. The Unified Parkinson's Disease Rating Scale (UPDRS) part III scores, the Rush scale for dyskinesias, and the total electrical energy delivered to the tissues per second (TEEDs) were significantly lower in the aDBS session (relative UPDRS mean, cDBS: 0.46 ± 0.05, aDBS: 0.33 ± 0.04, p = 0.015; UPDRS part III rigidity subset mean, cDBS: 2.9143 ± 0.6551 and aDBS: 2.1429 ± 0.5010, p = 0.034; UPDRS part III standard deviation cDBS: 2.95, aDBS: 2.68; p = 0.047; Rush scale, cDBS 2.79 ± 0.39 versus aDBS 1.57 ± 0.23, p = 0.037; cDBS TEEDs mean: 28.75 ± 3.36 µj s^-1, aDBS TEEDs mean: 16.47 ± 3.33, p = 0.032 Wilcoxon's sign rank test). This work further supports the safety and effectiveness of aDBS stimulation compared to cDBS in a daily session, both in terms of motor performance and TEED to the patient.