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Adaptive Deep Brain Stimulation as an Advanced Parkinson’s disease Treatment (ADAPT): a pseudorandomised clinical trial

Dan Piña-Fuentes, J. Marc C. van Dijk, Jonathan C. van Zijl, Harmen R. Moes, D. L. Marinus Oterdoom, Simon Little, Peter Brown, Martijn Beudel
doi: https://doi.org/10.1101/749903
Dan Piña-Fuentes
Department of Neurosurgery, University Medical Centre Groningen, The NetherlandsMedical Research Council Brain Network Dynamics Unit at the University of Oxford, United KingdomNuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom
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J. Marc C. van Dijk
Department of Neurosurgery, University Medical Centre Groningen, The Netherlands
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Jonathan C. van Zijl
Department of Neurology, University Medical Centre Groningen, The Netherlands
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Harmen R. Moes
Department of Neurology, University Medical Centre Groningen, The Netherlands
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D. L. Marinus Oterdoom
Department of Neurosurgery, University Medical Centre Groningen, The Netherlands
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Simon Little
Department of Movement Disorders and Neuromodulation, University of California San Francisco, USA
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Peter Brown
Medical Research Council Brain Network Dynamics Unit at the University of Oxford, United KingdomNuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom
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Martijn Beudel
Department of Neurology, University Medical Centre Groningen, The NetherlandsDepartment of Neurology, Amsterdam Neuroscience Institute, Amsterdam University Medical Centre, Amsterdam, The Netherlands
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  • For correspondence: m.beudel@amsterdamumc.nl
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Abstract

Beta-based adaptive Deep Brain Stimulation (aDBS) is effective in Parkinson’s disease (PD), when assessed in the immediate post-operative phase. However, potential benefits of aDBS on stimulation-induced side effects in chronically implanted patients are yet to be assessed. To determine the effectiveness and side-effect profile of aDBS in PD we compared to conventional DBS (cDBS) and no stimulation (NoStim) in the chronically implanted state. 13 PD patients undergoing battery replacement were pseudo-randomised in a crossover fashion, into three conditions (NoStim, aDBS or cDBS). Patient videos were blindly evaluated using a short version of the Unified Parkinson’s Disease Rating Scale (subUPDRS) and the Speech Intelligibility Test (SIT). subUPDRS scores were significantly lower both in aDBS (p=<.001), and cDBS (p=.001), when compared to NoStim. Bradykinesia subscores were significantly lower in aDBS (p=.002), but not in cDBS (p=.08), when compared to NoStim. SIT scores of patients with stimulation-induced dysarthria significantly worsened in cDBS (p=.009), but not in aDBS (p=.407), when compared to NoStim. Beta-based aDBS is effective for PD in chronically implanted patients, especially in controlling bradykinesia symptoms. Furthermore, aDBS has a more favourable speech side-effect profile than cDBS.

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The copyright holder for this preprint is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-ND 4.0 International license.
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Posted August 29, 2019.
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Adaptive Deep Brain Stimulation as an Advanced Parkinson’s disease Treatment (ADAPT): a pseudorandomised clinical trial
Dan Piña-Fuentes, J. Marc C. van Dijk, Jonathan C. van Zijl, Harmen R. Moes, D. L. Marinus Oterdoom, Simon Little, Peter Brown, Martijn Beudel
bioRxiv 749903; doi: https://doi.org/10.1101/749903
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Adaptive Deep Brain Stimulation as an Advanced Parkinson’s disease Treatment (ADAPT): a pseudorandomised clinical trial
Dan Piña-Fuentes, J. Marc C. van Dijk, Jonathan C. van Zijl, Harmen R. Moes, D. L. Marinus Oterdoom, Simon Little, Peter Brown, Martijn Beudel
bioRxiv 749903; doi: https://doi.org/10.1101/749903

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