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Abstract Details

Patient-Adjusted Deep Brain Stimulation Programming is Time-Saving in Dystonia Patients
Movement Disorders
P2 - Poster Session 2 (8:00 AM-9:00 AM)
3-006

To analyze whether programming a programming paradigm based on patient’s self-adjustment is practical, effective and time-saving in dystonia.
Deep brain stimulation (DBS) programming for dystonia patients is a complex and time-consuming task.
We retrospectively compared dystonia rating scales as well as the time necessary to optimize programming and the number of in-hospital visits in all patients (n= 102) operated at our centre who used simple mode (SM) or advanced mode (AM) programming; the latter uses groups of different stimulation parameters and allows the patient and their caregiver to change stimulation groups at home, using the patient remote control.
Both AM- and SM-allocated patients improved clinically to the same extent after DBS, as assessed by the Burke-Fahn-Marsden (BFM) and the Toronto Western Spasmodic Torticollis (TWSTRS) dystonia rating scales. All sub-scores improved after DBS without statistically significant differences in improvement between AM and SM (BFM: -43% vs. -53%, p=0.569; TWSTRS: -63% vs. -72%, p=0.781). AM and SM patients reached optimization within a similar median time (5.5 months [95%CI 4.6-6.3] for AM vs. 6.2 months [4.2-7.6] for SM, p=0.674) but patients on advanced programming needed fewer in-hospital visits to achieve the same improvement (median of 5 visits [95%CI 4-7] for AM vs. 8 visits [7-9] for SM, p=0.008).

Advanced DBS programming based on patient’s self-adjustment under the supervision of the treating physician is feasible, practical and significantly reduces consultation time in dystonia patients.
Authors/Disclosures
Julien F. Bally, MD (CHUV Centre Hospitalier Universitaire Vaudois)
PRESENTER 		No disclosure on file
Mohammad Rohani, MD (Movement Disorders Center,Toronto Western Hospital) Dr. Rohani has nothing to disclose.
No disclosure on file
Suneil Kalia Suneil Kalia has received personal compensation in the range of $0-$499 for serving as a Consultant for Abbott. Suneil Kalia has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boston. Suneil Kalia has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medtronic. Suneil Kalia has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novonordisk. The institution of Suneil Kalia has received research support from CIHR. Suneil Kalia has received research support from MJFF. The institution of Suneil Kalia has received research support from Parkinson Canada.
No disclosure on file
Andres M. Lozano, MD (Toronto Western Hosp) Dr. Lozano has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbott. Dr. Lozano has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Insightec. Dr. Lozano has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boston Scientific. Dr. Lozano has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medtronic. Dr. Lozano has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Functional Neuromodulation.
Renato P. Munhoz, MD, PhD Dr. Munhoz has nothing to disclose.
Alfonso Fasano, MD, PhD, FÂ鶹´«Ã½Ó³»­ (Toronto Western Hospital - U of Toronto) Dr. Fasano has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Abbott. Dr. Fasano has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Abbvie. Dr. Fasano has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ipsen. Dr. Fasano has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Medtronic. Dr. Fasano has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Boston Scientific. Dr. Fasano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbott. Dr. Fasano has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medtronic. Dr. Fasano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Ceregate. Dr. Fasano has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Inbrain Neuroelectronics. Dr. Fasano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Syneos Health. Dr. Fasano has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Annovis. Dr. Fasano has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for CADTH. Dr. Fasano has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for International Parkinson and Movement Disorders Society. The institution of Dr. Fasano has received research support from Boston Scientific. The institution of Dr. Fasano has received research support from Medtronic. The institution of Dr. Fasano has received research support from Abbvie. The institution of Dr. Fasano has received research support from Canadian Institutes of Health Research (CIHR). The institution of Dr. Fasano has received research support from Michael J Fox Foundation. The institution of Dr. Fasano has received research support from Bluerock Therapeutics. Dr. Fasano has received publishing royalties from a publication relating to health care. Dr. Fasano has a non-compensated relationship as a Medical Advisory Committee with CenteR for Advancing Neurological Innovation to Application (CRANIA) that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Fasano has a non-compensated relationship as a Medical Advisory Committee with HopeNET that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Fasano has a non-compensated relationship as a Medical Advisory Committee with International Essential Tremor Foundation that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Fasano has a non-compensated relationship as a Member with Tremor Research Group that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Fasano has a non-compensated relationship as a Co-Chair with Tremor Study Group of the IPMDS that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Fasano has a non-compensated relationship as a Vice-Chair with NPH Study Group of the IPMDS that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Fasano has a non-compensated relationship as a Vice-Chair with Industry Committee of the IPMDS that is relevant to Â鶹´«Ã½Ó³»­ interests or activities.