Abstract Details

Title Correlation of Electrode Location and Outcomes of Gait and Axial Function in Parkinson’s Disease Patients managed with Subthalamic Deep Brain Stimulation

Topic Movement Disorders

Presentation(s) P1 - Poster Session 1 (5:30 PM-6:30 PM)

Poster/Presentation
Number 10-020

Objective

To examine the relationship between subthalamic nucleus-deep brain stimulation (STN-DBS) contact activation and gait/axial outcomes in Parkinson’s disease (PD) patients.

Background

Bilateral STN-DBS provides improvement in PD motor symptoms; however, gait disturbance and axial function deficits may arise. Previous studies report that patients had a clinically worsening of gait several years after STN-DBS and changes in programming and medical management allowed for improvement in these symptoms to some degree. Programming settings, electrode localization and stimulation of certain STN areas may be associated with improved gait outcomes.

Design/Methods We retrospectively reviewed data (MDS-UPDRS III subscores, and DBS settings) from twenty-five PD patients with STN-DBS implanted between 2014 and 2015 and post-operative data for 3 years. Measures of axial function included posture (UPDRS item 28), gait (item 29), postural stability (item 30), and PIGD (items 27–30). Wilcoxon’s test and Two-way ANOVA were used according to data distribution. Lead localization was verified using a postoperative CT scan fused with preoperative stereotactic MRI. Contact 0 and 1 were considered as ventral contact. Contact 2 and 3 were considered as dorsal contact.

Results Posture, gait and PIGD MDS-UPDRS III subscores in STN-DBS patients significantly improved from baseline off medication (P<0.05, P<0.01 and P<0.05 individually). There is no significant difference of stimulation frequency and pulse width between post-operative year 1, year 2 and year 3. Stimulation of ventral contact showed consistent improvement of gait and axial functions as compared to stimulation of dorsal contact at year 3 (P<0.05). There was significant and consistent improvement of motor functions after STN-DBS (51% at MDS-UPDRS motor score year 1 compared with baseline off medication, P<0.01; 42% at year 3, P<0.01).

Conclusions Our study indicates gait and axial functions improve following STN-DBS implantation. Ventral contact stimulation might be associated with consistent improvement of outcomes in gait and axial functions after STN-DBS.

Authors/Disclosures
Yonglu Huang, MD, PhD (Doylestown Health) PRESENTER	No disclosure on file
Andres F. Deik Acosta Madiedo, MD, FAAN (University of Pennsylvania)	Dr. Deik Acosta Madiedo has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amneal Pharmaceuticals. Dr. Deik Acosta Madiedo has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for SPARK-NS. Dr. Deik Acosta Madiedo has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Manifold Bio. Dr. Deik Acosta Madiedo has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genus Lifesciences. Dr. Deik Acosta Madiedo has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Supernus Therapeutics. Dr. Deik Acosta Madiedo has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amneal. The institution of Dr. Deik Acosta Madiedo has received research support from Teva Pharmaceuticals. The institution of Dr. Deik Acosta Madiedo has received research support from Cerevel Therapeutics. The institution of Dr. Deik Acosta Madiedo has received research support from Prevail Therapeutics. The institution of Dr. Deik Acosta Madiedo has received research support from Lundbeck Therapeutics. The institution of Dr. Deik Acosta Madiedo has received research support from AskBio. The institution of Dr. Deik Acosta Madiedo has received research support from Annovis Bio. The institution of Dr. Deik Acosta Madiedo has received research support from Ono pharmaceuticals. The institution of Dr. Deik Acosta Madiedo has received research support from Amylyx therapeutics. The institution of Dr. Deik Acosta Madiedo has received research support from Dystonia Coalition/Dystonia Medical Research Foundation. Dr. Deik Acosta Madiedo has received publishing royalties from a publication relating to health care. Dr. Deik Acosta Madiedo has received publishing royalties from a publication relating to health care. Dr. Deik Acosta Madiedo has received personal compensation in the range of $5,000-$9,999 for serving as a Speaker with PeerView CME.
Meredith Spindler, MD, FAAN	Dr. Spindler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medtronic. The institution of Dr. Spindler has received research support from Abbvie. The institution of Dr. Spindler has received research support from Supernus. The institution of Dr. Spindler has received research support from Abbott. The institution of Dr. Spindler has received research support from Takeda. The institution of Dr. Spindler has received research support from Praxis. The institution of Dr. Spindler has received research support from UCB. Dr. Spindler has received publishing royalties from a publication relating to health care.
Adolfo Ramirez Zamora, MD (University of Louisville)	Dr. Ramirez Zamora has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Medtronic. Dr. Ramirez Zamora has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cerevel therapeutics. Dr. Ramirez Zamora has received personal compensation in the range of $0-$499 for serving as a Consultant for NeuroPacs. Dr. Ramirez Zamora has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boston Scientific. Dr. Ramirez Zamora has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Iota Inc. Dr. Ramirez Zamora has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Maplight. Dr. Ramirez Zamora has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NIH. The institution of Dr. Ramirez Zamora has received research support from Parkinsons Foundation.

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