Automated Deep Brain Stimulation Programming for Tremor.

Published

Journal Article

Deep brain stimulation (DBS) programming, the systematic selection of fixed electrical stimulation parameters that deliver maximal therapeutic benefit while limiting side effects, poses several challenges in the treatment of movement disorders. DBS programming requires the expertise of trained neurologists or nurses who assess patient symptoms according to standardized clinical rating scales and use patient reports of DBS-related side effects to adjust stimulation parameters and optimize therapy. In this paper, we describe and validate an automated software platform for DBS programming for tremor associated with Parkinson's disease and essential tremor. DBS parameters are changed automatically through a direct computer interface with implanted neurostimulators. Each tested DBS setting is ranked according to its effect on tremor, which is assessed using smartwatch inertial measurement unit data, and side effects, which are reported through a user interface. Blinded neurologist assessments showed the automated programming method performed at least as well as clinician mediated programming in selecting the optimal settings for tremor therapy. This proof of concept study describes a novel DBS programming paradigm that may improve programming efficiency and outcomes, increase access to programming outside specialty clinics, and aid in the development of adaptive and closed-loop DBS strategies.

Full Text

Duke Authors

Cited Authors

  • Haddock, A; Mitchell, KT; Miller, A; Ostrem, JL; Chizeck, HJ; Miocinovic, S

Published Date

  • August 2018

Published In

Volume / Issue

  • 26 / 8

Start / End Page

  • 1618 - 1625

PubMed ID

  • 29994714

Pubmed Central ID

  • 29994714

Electronic International Standard Serial Number (EISSN)

  • 1558-0210

Digital Object Identifier (DOI)

  • 10.1109/TNSRE.2018.2852222

Language

  • eng

Conference Location

  • United States