PT  - JOURNAL ARTICLE
AU  - Dan Piña-Fuentes
AU  - J. Marc C. van Dijk
AU  - Jonathan C. van Zijl
AU  - Harmen R. Moes
AU  - D. L. Marinus Oterdoom
AU  - Simon Little
AU  - Peter Brown
AU  - Martijn Beudel
TI  - Adaptive Deep Brain Stimulation as an Advanced Parkinson’s disease Treatment (ADAPT): a pseudorandomised clinical trial
AID  - 10.1101/749903
DP  - 2019 Jan 01
TA  - bioRxiv
PG  - 749903
4099  - http://biorxiv.org/content/early/2019/08/29/749903.short
4100  - http://biorxiv.org/content/early/2019/08/29/749903.full
AB  - 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.