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Abstract Details

Sustained Benefits of Deep Brain Stimulation of the Subthalamic Nucleus: A Five-year Analysis of an Implantable Neurostimulator for the Treatment of Parkinson’s disease (INTREPID)
Movement Disorders
P9 - Poster Session 9 (11:45 AM-12:45 PM)
5-007
The INTREPID study had two phases: a double-blind, sham-controlled, multicenter, randomized efficacy phase followed by an open-label phase. Here, we present outcomes from the 5-year open-label phase evaluating long-term effectiveness of subthalamic nucleus (STN) deep brain stimulation (DBS).  
DBS is widely recognized as a highly effective therapy for improving motor function and quality-of- life in patients with moderate to severe Parkinson’s disease (PD). The INTREPID study was designed to provide class I evidence for the use of STN-DBS in the control of PD motor symptoms and to evaluate efficacy of a novel multiple independent constant current-controlled DBS device. 

During the open label phase, subjects returned to the clinic for evaluation and programming at 20-, 26-, 48-, 52-, 78-weeks, 2-, 3-, 4-, 5-Year post-DBS randomization. Evaluated efficacy outcomes included but were not limited to UPDRS I-IV in meds ON and OFF condition, PDQ-39, and treatment satisfaction. Additionally, individual motor symptoms (assessed by parts of UPDRS III) were also analyzed per the following: rigidity, bradykinesia, and tremor (rest and postural).  

Significant improvements were observed in UPDRS III scores (meds off), with motor function improvement by 51% at Year 1, and remained improved by 36% by Year 5. Furthermore, analysis of UDPRS III (meds off) sub-categories showed sustained improvement in tremor, rigidity, bradykinesia. UPDRS II scores showed a 40% improvement in activities of daily living compared to screening at Year 1, decreasing to 20% improvement by Year 5.   

This 5-year data demonstrates that STN-DBS provides significant and sustained improvements in motor function and activities of daily living. Patient satisfaction with treatment remained high throughout the study and safety outcomes were consistent with previously reported trials.  Collectively, these findings support use of subthalamic DBS in patients with moderate to advanced PD who no longer achieve adequate symptom control with medications alone. 

Authors/Disclosures
Jill L. Ostrem, MD, FAAN (UCSF)
PRESENTER
Dr. Ostrem has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Jazz . Dr. Ostrem has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Superness. Dr. Ostrem has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AcureX. Dr. Ostrem has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Larimar. Dr. Ostrem has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Aspen. Dr. Ostrem has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Movement Disorders. The institution of Dr. Ostrem has received research support from Neuroderm. The institution of Dr. Ostrem has received research support from Boston Scientific. The institution of Dr. Ostrem has received research support from Medtronic. The institution of Dr. Ostrem has received research support from Rune.
Jerrold L. Vitek, MD, PhD (UMN Neurology) Dr. Vitek has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Boston Scientific. Dr. Vitek has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Abbott. Dr. Vitek has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medtronic. Dr. Vitek has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Surgical Information Sciences. Dr. Vitek has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Surgical Information Sciences. Dr. Vitek has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbott. Dr. Vitek has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Boston Scientific. The institution of Dr. Vitek has received research support from NINDS.
Rajat Shivacharan Dr. Shivacharan has received personal compensation for serving as an employee of Boston Scientific.
Edward Goldberg, MD Dr. Goldberg has received personal compensation for serving as an employee of Boston Scientific .