Abstract Details

Title Real-world Outcomes with Directional Deep Brain Stimulation (DBS) Systems: Awake Versus Asleep Lead Placement

Topic Movement Disorders

Presentation(s) P9 - Poster Session 9 (11:45 AM-12:45 PM)

Poster/Presentation
Number 5-011

Objective We compare real-world outcomes of Parkinson's disease (PD) patients using Deep Brain Stimulation (DBS) systems based on patients being awake or asleep during lead placement procedures.

Background Conducting DBS procedures with patients asleep (i.e., under general anesthesia) has becoming increasingly popular due to patient preference, programming flexibility with directional leads, and advances in imaging technology. Previous work assessing those undergoing awake versus asleep DBS procedures has demonstrated no difference in cognition, mood, and/or behavioral adverse effects.

Design/Methods This is a prospective, on-label, multicenter, international real-world evaluation of subjects who received multiple-source, constant-current directional DBS systems (Boston Scientific) for treatment of PD. Based on sites' standard-of-care and preferred technique, DBS procedures were performed with subjects awake or asleep during lead placement. Subjects were followed up to 3-years post-implantation and quality-of-life and PD motor symptoms was evaluated. Endpoints evaluated at baseline and study follow-ups included Unified Parkinson's disease Rating Scale (UPDRS), MDS-UPDRS Ill (converted), Parkinson's disease Questionnaire (PDQ-39), and Global Impression of Change.

Results Of 977 implanted patients in the study, 278 patients (mean age = 61.5±7.8 years, 64% male) were asleep during lead placement and 699 (mean age= 60.3±8.7 years, 69% male) were awake. Improvement in quality-of-life as assessed by PDQ-39 was noted in both groups with the asleep group reporting a 4.7-point improvement and the awake group reporting a 5.0-point improvement at 1-year. Similarly, a 18.7- and 17.0-point improvement in converted MDS-UPDRS Ill scores (meds off) was noted in asleep and awake groups, respectively. Additional and updated data collected since last analysis will be provided.

Conclusions Preliminary results show that motor function related, and quality-of-life outcomes show little to no difference between groups who received leads during DBS procedures whether awake versus asleep (i.e., under general anesthesia). Asleep DBS procedures have potential to shorten total time taken for DBS procedures.

Authors/Disclosures
Guenther Deuschl, MD, FAAN (Dept. of Neurology, Christain-Albrechts Univ) PRESENTER	Dr. Deuschl has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boston Scientific. Dr. Deuschl has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Boston Scientific Cavion Functional Neuromodulation. The institution of Dr. Deuschl has received research support from Medtronic. Dr. Deuschl has received publishing royalties from a publication relating to health care.
jan vesper, MD, PhD	Prof. vesper has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Boston Scientific .
Lilly Chen (Boston Scientific)	Lilly Chen has received personal compensation for serving as an employee of Boston Scientific .
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 .

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