IProgramming Time and the Use of a Visualization Tool for DBS Programming of a Multiple-Source, Constant-Current System (P5-11.006)

Congratulations to Drs. Michael Okun and Kelly Foote on the publication of “Programming Time and the Use of a Visualization Tool for DBS Programming of a Multiple-Source, Constant-Current System (P5-11.006),” in the May issue of Neurology.


Objective: We describe utilization of a visualization software for use as a deep brain stimulation (DBS) planning tool during the initial device programming in a Parkinson’s disease (PD) cohort.

Background: Optimization of DBS programming usually consists of an empirical trial-and-error process involving appraisal of various stimulation parameters to determine optimal settings. This process can be inefficient, lengthy and burdensome for the patient. The use of a visualization tool capable of illustrating the location of the DBS lead within the individual’s segmented anatomy and volume of tissue activated (VTA) may have the potential to improve optimization and outcomes.

Design/Methods: A novel visualization software (GUIDE XT, Boston Scientific) was utilized in an ongoing prospective, multicenter, registry (NCT02071134) which utilizes pre-op MRI and post-op CT to allow identification of the location of the lead relative to anatomical targets and VTAs. The goal of the current study was to determine whether the tool shortened the duration of initial programming. The time to reach effective stimulation settings during the initial programming session was collected (pre-processing of images not included).

Results: To date, 37 patients enrolled and 22 completed initial DBS programming. Initial programming sessions (post-implant), using the visualization software were completed in 24.8 ± 11.2 minutes (mean +/− SD, n=17) and in 76% of subjects in < 30 minutes.

Conclusions: Preliminary results from this ongoing, open-label, prospective study utilizing a visualization tool suggests shorter initial programming sessions than reported for traditional trial-and-error approach (~140 min) (Pavese N., et al World Neurosurg 2020). Additionally, time to pre-process images will also need to be factored in, and the equivalence of outcomes needs to be ascertained. Shorter, more efficient programming sessions have the potential to improve overall satisfaction and resource utilization.