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BackgroundThe efficacy of deep brain stimulation (DBS) for Parkinson's disease (PD) depends on optimizing stimulation parameters for each patient, a time-sensitive process. Image-guided programming (IGP) offers a promising method to streamline this.ObjectiveThe objective was to evaluate the real-world effectiveness of an IGP tool with directional leads during the initial programming of bilateral subthalamic nucleus (STN) or globus pallidus internus (GPi) DBS in PD patients.MethodsA total of 57 PD patients (46 bilateral STN, 11 bilateral GPi) from the Vercise DBS Registry (NCT#02071134) were enrolled into the GUIDE XT substudy. Time for initial programming using IGP, Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part III at baseline, 6-months, and 1-year postactivation, Global Impression of Change from patients and clinicians, and the continued use of IGP-suggested settings were analyzed. Stimulation field model (SFM) overlap between initial and 1-year target volumes was also examined.ResultsMotor function significantly improved at 6 months and 1 year (55% and 45%, P ConclusionsIGP facilitates efficient initial programming sessions, providing stable settings that result in long-term motor improvements.
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