Abstract Details

Title Evaluation of Predictors of Treatment Response in Subthalamic Nucleus Deep Brain Stimulation for Parkinson’s Disease Using Connectomics and Wearable Sensors

Topic Movement Disorders

Presentation(s) P1 - Poster Session 1 (8:00 AM-9:00 AM)

Poster/Presentation
Number 3-010

Objective To evaluate a method to provide comprehensive symptom monitoring and models of tract-specific modulation before and after Subthalamic Nucleus (STN) Deep Brain Stimulation (DBS) for Parkinson’s Disease.

Background

Parkinson’s Disease is a prevalent neurodegenerative disorder that affects over 8.5 million people worldwide. DBS helps treat motor fluctuations and/or dyskinesia in advancing disease. DBS programming occurs in a time intensive trial/error fashion without insight into how activation of specific tracts may create a personalized treatment paradigm for each patient. Programming settings are also performed based on static exam findings, unable to consider fluctuations of symptoms over time.

Design/Methods We established a framework for collecting a comprehensive dataset that considers granular exam findings at clinic visits (Movement Disorders Society Unified Parkinson Disease Rating Scale [MDS-UPDRS] for bradykinesia, tremor, rigidity, and gait/posture), longitudinal symptom tracking with wearable devices (tremor/dyskinesia probability), and modeling of tract activation based on lead placement. We analyzed this data pre- and post-DBS implantation in six patients who underwent bilateral STN placement.

Results We observed changes in MDS-UPDRS scores and wearable symptom tracking pre- and post-DBS that allow for dynamic measurements in a patient-specific manner. The results demonstrate the use of wearable data as a continuous stream of information to evaluate the interplay between medications and stimulation paradigm and how this differentially affects each individual patient in a disease that can fluctuate hour to hour. We also show how tract activation models and imaging can allow for a granular analysis of symptom control. Preliminarily, we found a possible trend towards rigidity control and cerebellothalamic tract activation and bradykinesia control and hyperdirect tract activation. The model showed there was minimal activation of the internal capsule tract in these subjects (n=6).

Conclusions We demonstrate a multi-modal approach to assessing treatment response after DBS in patients with Parkinson’s Disease.

Authors/Disclosures
Tanziyah Muqeem, MD, PhD PRESENTER	An immediate family member of Dr. Muqeem has received personal compensation for serving as an employee of GSK. An immediate family member of Dr. Muqeem has stock in GSK. An immediate family member of Dr. Muqeem has stock in Sanofi. An immediate family member of Dr. Muqeem has stock in J&J. An immediate family member of Dr. Muqeem has stock in Abbvie. An immediate family member of Dr. Muqeem has stock in Merck. An immediate family member of Dr. Muqeem has stock in Bristol-Myers Squibb. An immediate family member of Dr. Muqeem has stock in AstraZeneca. An immediate family member of Dr. Muqeem has stock in Haleon. An immediate family member of Dr. Muqeem has stock in Gilead. An immediate family member of Dr. Muqeem has stock in CVS Health. An immediate family member of Dr. Muqeem has stock in Walgreens. Dr. Muqeem has received intellectual property interests from a discovery or technology relating to health care. Dr. Muqeem has a non-compensated relationship as a Advisor with Hoth Intelligence that is relevant to AAN interests or activities.
Angela Noecker (Duke University)	No disclosure on file
Alaa Norain (Duke)	No disclosure on file
Tiffany Tran	No disclosure on file
Cameron McIntyre (Duke University)	No disclosure on file
Kyle T. Mitchell, MD (Duke University Movement Disorders Center)	Dr. Mitchell has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boston Scientific. The institution of Dr. Mitchell has received research support from Medtronic. The institution of Dr. Mitchell has received research support from Deep Brain Innovations. The institution of Dr. Mitchell has received research support from National Institutes of Health. The institution of Dr. Mitchell has received research support from National Institute on Aging.

��ɫ��

��ɫ��