dc.creator | Schnitzler, A. | es |
dc.creator | Mir Rivera, Pablo | es |
dc.creator | Brodsky, M. A. | es |
dc.creator | Verhagen, L. | es |
dc.creator | Groppa, S. | es |
dc.creator | Álvarez, R. | es |
dc.creator | Vesper, J. | es |
dc.date.accessioned | 2022-10-28T15:33:45Z | |
dc.date.available | 2022-10-28T15:33:45Z | |
dc.date.issued | 2021 | |
dc.identifier.citation | Schnitzler, A., Mir Rivera, P., Brodsky, M.A., Verhagen, L., Groppa, S., Álvarez, R. y Vesper, J. (2021). Directional deep brain stimulation for Parkinson's disease: results of an international crossover study with randomized, double-blind primary endpoint. Neuromodulation. https://doi.org/10.1111/ner.13407. | |
dc.identifier.issn | 1094-7159 | es |
dc.identifier.uri | https://hdl.handle.net/11441/138479 | |
dc.description.abstract | Objective: Published reports on directional deep brain stimulation (DBS) have been limited to small, single-center investigations.
Therapeutic window (TW) is used to describe the range of stimulation amplitudes achieving symptom relief without side effects.
This crossover study performed a randomized double-blind assessment of TW for directional and omnidirectional DBS in a large
cohort of patients implanted with a DBS system in the subthalamic nucleus for Parkinson’s disease.
Materials and Methods: Participants received omnidirectional stimulation for the first three months after initial study pro gramming, followed by directional DBS for the following three months. The primary endpoint was a double-blind, randomized
evaluation of TW for directional vs omnidirectional stimulation at three months after initial study programming. Additional data
recorded at three- and six-month follow-ups included stimulation preference, therapeutic current strength, Unified Parkinson’s
Disease Rating Scale (UPDRS) part III motor score, and quality of life.
Results: The study enrolled 234 subjects (62 ± 8 years, 33% female). TW was wider using directional stimulation in 183 of 202
subjects (90.6%). The mean increase in TW with directional stimulation was 41% (2.98 ± 1.38 mA, compared to 2.11 ± 1.33 mA for
omnidirectional). UPDRS part III motor score on medication improved 42.4% at three months (after three months of omnidi rectional stimulation) and 43.3% at six months (after three months of directional stimulation) with stimulation on, compared to
stimulation off. After six months, 52.8% of subjects blinded to stimulation type (102/193) preferred the period with directional
stimulation, and 25.9% (50/193) preferred the omnidirectional period. The directional period was preferred by 58.5% of clinicians
(113/193) vs 21.2% (41/193) who preferred the omnidirectional period.
Conclusion: Directional stimulation yielded a wider TW compared to omnidirectional stimulation and was preferred by blinded
subjects and clinicians. | es |
dc.format | application/pdf | es |
dc.format.extent | 12 p. | es |
dc.language.iso | eng | es |
dc.publisher | Blackwell Publishing INC | es |
dc.relation.ispartof | Neuromodulation. | |
dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 Internacional | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | * |
dc.subject | Deep brain stimulation | es |
dc.subject | Directional programming | es |
dc.subject | Parkinson’s disease | es |
dc.subject | Therapeutic window | es |
dc.title | Directional deep brain stimulation for Parkinson's disease: results of an international crossover study with randomized, double-blind primary endpoint | es |
dc.type | info:eu-repo/semantics/article | es |
dcterms.identifier | https://ror.org/03yxnpp24 | |
dc.type.version | info:eu-repo/semantics/publishedVersion | es |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | es |
dc.contributor.affiliation | Universidad de Sevilla. Departamento de Medicina | es |
dc.relation.publisherversion | https://www.sciencedirect.com/science/article/pii/S1094715921064230?via%3Dihub | es |
dc.identifier.doi | 10.1111/ner.13407 | es |
dc.contributor.group | Universidad de Sevilla. CTS630: Trastornos del Movimiento | es |
dc.journaltitle | Neuromodulation | es |