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Abstract Details

Real-World Outcomes Using a Novel Directional Lead from a Multicenter DBS Registry for Parkinson's Disease
Movement Disorders
Movement Disorders Posters (7:00 AM-5:00 PM)
100
 In this report, real-world outcomes using Directional DBS Systems with multiple independent current source control (MICC) for use in managing symptoms of levodopa-responsive Parkinson's disease (PD) are reported.
Early Deep Brain Stimulation (DBS) systems used ring-shaped electrodes to achieve axial selectivity in stimulation of target tissue. However, directional current steering allows for rotational selectivity (in addition to axial) and has the potential to further improve patient outcomes by avoiding off-target stimulation due to the ability to create a well-defined field around the intended target.
The Vercise DBS Registry (NCT02071134) is a prospective, on-label, multi-center, international registry sponsored by Boston Scientific. Subjects were implanted with a directional lead included as part of a multiple-source, constant-current directional DBS system (Vercise Cartesia, Boston Scientific). Subjects were followed up to 3-years post-implantation where their overall improvement in quality of life and PD motor symptoms was evaluated. Clinical endpoints evaluated at baseline and during study follow-up included Unified Parkinson's disease Rating Scale (UPDRS), MDS-UPDRS, Parkinson's disease Questionnaire (PDQ-39), and Global Impression of Change.
As of March 2020, 433 subjects were implanted (mean age: 60.8 years, 70.3% male). Improved Quality of Life, as assessed by PDQ-39 (p < 0.0001) following implant was noted up to 1-year post-implant (n = 240). Several sub-domains such as Activities of Daily Living, Bodily discomfort showed sustained improvement (p<0.0001). Improvements in motor function (change in MDS-UPDRS III scores-meds off condition) was also reported (p < 0.0001). Over 90% of subjects, physicians noted an improvement in PD symptoms during long term-follow up. Additional data is to be presented.
Enabling fractionalization of current using MICC can permit application of a well-defined, shaped, electrical field. This ongoing registry represents the first comprehensive, large scale collection of real-world outcomes using a directional lead and an MICC-based DBS system.
Authors/Disclosures
Guenther Deuschl, MD, FÂé¶¹´«Ã½Ó³»­ (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.
Roshini Jain Roshini Jain has received personal compensation for serving as an employee of Boston Scientific. Roshini Jain has received stock or an ownership interest from Boston Scientific.
No disclosure on file
No disclosure on file
Steffen Paschen The institution of Steffen Paschen has received research support from Deutsche Forschungsgemeinschaft. The institution of Steffen Paschen has received research support from Parkinsonfonds. The institution of Steffen Paschen has received research support from UCB .
Chong S. Lee, MD, FRCPC (CHA Bundang Medical Center, CHA University) Dr. Lee has nothing to disclose.
Andrea Kuehn Andrea Kuehn has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Medtronic. Andrea Kuehn has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Boston Scientific.
No disclosure on file