PMID- 29444973
OWN - NLM
STAT- MEDLINE
DCOM- 20190805
LR  - 20190805
IS  - 1526-632X (Electronic)
IS  - 0028-3878 (Print)
IS  - 0028-3878 (Linking)
VI  - 90
IP  - 11
DP  - 2018 Mar 13
TI  - Eight-hours adaptive deep brain stimulation in patients with Parkinson disease.
PG  - e971-e976
LID - 10.1212/WNL.0000000000005121 [doi]
AB  - OBJECTIVES: To assess the feasibility and clinical efficacy of local field 
      potentials (LFPs)-based adaptive deep brain stimulation (aDBS) in patients with 
      advanced Parkinson disease (PD) during daily activities in an open-label, 
      nonblinded study. METHODS: We monitored neurophysiologic and clinical 
      fluctuations during 2 perioperative experimental sessions lasting for up to 8 
      hours. On the first day, the patient took his/her daily medication, while on the 
      second, he/she additionally underwent subthalamic nucleus aDBS driven by LFPs 
      beta band power. RESULTS: The beta band power correlated in both experimental 
      sessions with the patient's clinical state (Pearson correlation coefficient r = 
      0.506, p < 0.001, and r = 0.477, p < 0.001). aDBS after LFP changes was effective 
      (30% improvement without medication [3-way analysis of variance, interaction day 
      x medication p = 0.036; 30.5 +/- 3.4 vs 22.2 +/- 3.3, p = 0.003]), safe, and well 
      tolerated in patients performing regular daily activities and taking additional 
      dopaminergic medication. aDBS was able to decrease DBS amplitude during motor 
      "on" states compared to "off" states (paired t test p = 0.046), and this 
      automatic adjustment of STN-DBS prevented dyskinesias. CONCLUSIONS: The main 
      findings of our study are that aDBS is technically feasible in everyday life and 
      provides a safe, well-tolerated, and effective treatment method for the 
      management of clinical fluctuations. CLASSIFICATION OF EVIDENCE: This study 
      provides Class IV evidence that for patients with advanced PD, aDBS is safe, well 
      tolerated, and effective in controlling PD motor symptoms.
CI  - Copyright (c) 2018 The Author(s). Published by Wolters Kluwer Health, Inc. on 
      behalf of the American Academy of Neurology.
FAU - Arlotti, Mattia
AU  - Arlotti M
AD  - From the Clinical Center for Neurotechnologies, Neuromodulation, and Movement 
      Disorders (M.A., S.M., F.C., T.B., F.C., P.R., S.B.), Fondazione IRCCS Ca'Granda 
      Ospedale Maggiore Policlinico, Milano; Dipartimento di Ingegneria e Architettura 
      (S.M., M.P.), Universita degli Studi di Trieste, Italy; CINAC (G.F.), Hospital 
      Universitario HM Puerta del Sur, and Hospital Nacional de Paraplejicos, Toledo, 
      Spain; Department of Neurology (J.V.), University of Wurzburg, Germany; Division 
      of Neurosurgery (A.M.L.), University of Toronto, ON, Canada; Division of 
      Neurology (E.M.), Centre Hospitalier Universitaire de Grenoble, France; 
      Department of Medico-Surgical Sciences and Biotechnologies (F.C.), Sapienza 
      University Rome Polo Pontino, Rome; and "Aldo Ravelli" Research Center (A.P.), 
      Department of Health Sciences, University of Milan & Ospedale San Paolo, Milan, 
      Italy.
FAU - Marceglia, Sara
AU  - Marceglia S
AD  - From the Clinical Center for Neurotechnologies, Neuromodulation, and Movement 
      Disorders (M.A., S.M., F.C., T.B., F.C., P.R., S.B.), Fondazione IRCCS Ca'Granda 
      Ospedale Maggiore Policlinico, Milano; Dipartimento di Ingegneria e Architettura 
      (S.M., M.P.), Universita degli Studi di Trieste, Italy; CINAC (G.F.), Hospital 
      Universitario HM Puerta del Sur, and Hospital Nacional de Paraplejicos, Toledo, 
      Spain; Department of Neurology (J.V.), University of Wurzburg, Germany; Division 
      of Neurosurgery (A.M.L.), University of Toronto, ON, Canada; Division of 
      Neurology (E.M.), Centre Hospitalier Universitaire de Grenoble, France; 
      Department of Medico-Surgical Sciences and Biotechnologies (F.C.), Sapienza 
      University Rome Polo Pontino, Rome; and "Aldo Ravelli" Research Center (A.P.), 
      Department of Health Sciences, University of Milan & Ospedale San Paolo, Milan, 
      Italy.
FAU - Foffani, Guglielmo
AU  - Foffani G
AD  - From the Clinical Center for Neurotechnologies, Neuromodulation, and Movement 
      Disorders (M.A., S.M., F.C., T.B., F.C., P.R., S.B.), Fondazione IRCCS Ca'Granda 
      Ospedale Maggiore Policlinico, Milano; Dipartimento di Ingegneria e Architettura 
      (S.M., M.P.), Universita degli Studi di Trieste, Italy; CINAC (G.F.), Hospital 
      Universitario HM Puerta del Sur, and Hospital Nacional de Paraplejicos, Toledo, 
      Spain; Department of Neurology (J.V.), University of Wurzburg, Germany; Division 
      of Neurosurgery (A.M.L.), University of Toronto, ON, Canada; Division of 
      Neurology (E.M.), Centre Hospitalier Universitaire de Grenoble, France; 
      Department of Medico-Surgical Sciences and Biotechnologies (F.C.), Sapienza 
      University Rome Polo Pontino, Rome; and "Aldo Ravelli" Research Center (A.P.), 
      Department of Health Sciences, University of Milan & Ospedale San Paolo, Milan, 
      Italy.
FAU - Volkmann, Jens
AU  - Volkmann J
AD  - From the Clinical Center for Neurotechnologies, Neuromodulation, and Movement 
      Disorders (M.A., S.M., F.C., T.B., F.C., P.R., S.B.), Fondazione IRCCS Ca'Granda 
      Ospedale Maggiore Policlinico, Milano; Dipartimento di Ingegneria e Architettura 
      (S.M., M.P.), Universita degli Studi di Trieste, Italy; CINAC (G.F.), Hospital 
      Universitario HM Puerta del Sur, and Hospital Nacional de Paraplejicos, Toledo, 
      Spain; Department of Neurology (J.V.), University of Wurzburg, Germany; Division 
      of Neurosurgery (A.M.L.), University of Toronto, ON, Canada; Division of 
      Neurology (E.M.), Centre Hospitalier Universitaire de Grenoble, France; 
      Department of Medico-Surgical Sciences and Biotechnologies (F.C.), Sapienza 
      University Rome Polo Pontino, Rome; and "Aldo Ravelli" Research Center (A.P.), 
      Department of Health Sciences, University of Milan & Ospedale San Paolo, Milan, 
      Italy.
FAU - Lozano, Andres M
AU  - Lozano AM
AD  - From the Clinical Center for Neurotechnologies, Neuromodulation, and Movement 
      Disorders (M.A., S.M., F.C., T.B., F.C., P.R., S.B.), Fondazione IRCCS Ca'Granda 
      Ospedale Maggiore Policlinico, Milano; Dipartimento di Ingegneria e Architettura 
      (S.M., M.P.), Universita degli Studi di Trieste, Italy; CINAC (G.F.), Hospital 
      Universitario HM Puerta del Sur, and Hospital Nacional de Paraplejicos, Toledo, 
      Spain; Department of Neurology (J.V.), University of Wurzburg, Germany; Division 
      of Neurosurgery (A.M.L.), University of Toronto, ON, Canada; Division of 
      Neurology (E.M.), Centre Hospitalier Universitaire de Grenoble, France; 
      Department of Medico-Surgical Sciences and Biotechnologies (F.C.), Sapienza 
      University Rome Polo Pontino, Rome; and "Aldo Ravelli" Research Center (A.P.), 
      Department of Health Sciences, University of Milan & Ospedale San Paolo, Milan, 
      Italy.
FAU - Moro, Elena
AU  - Moro E
AD  - From the Clinical Center for Neurotechnologies, Neuromodulation, and Movement 
      Disorders (M.A., S.M., F.C., T.B., F.C., P.R., S.B.), Fondazione IRCCS Ca'Granda 
      Ospedale Maggiore Policlinico, Milano; Dipartimento di Ingegneria e Architettura 
      (S.M., M.P.), Universita degli Studi di Trieste, Italy; CINAC (G.F.), Hospital 
      Universitario HM Puerta del Sur, and Hospital Nacional de Paraplejicos, Toledo, 
      Spain; Department of Neurology (J.V.), University of Wurzburg, Germany; Division 
      of Neurosurgery (A.M.L.), University of Toronto, ON, Canada; Division of 
      Neurology (E.M.), Centre Hospitalier Universitaire de Grenoble, France; 
      Department of Medico-Surgical Sciences and Biotechnologies (F.C.), Sapienza 
      University Rome Polo Pontino, Rome; and "Aldo Ravelli" Research Center (A.P.), 
      Department of Health Sciences, University of Milan & Ospedale San Paolo, Milan, 
      Italy.
FAU - Cogiamanian, Filippo
AU  - Cogiamanian F
AD  - From the Clinical Center for Neurotechnologies, Neuromodulation, and Movement 
      Disorders (M.A., S.M., F.C., T.B., F.C., P.R., S.B.), Fondazione IRCCS Ca'Granda 
      Ospedale Maggiore Policlinico, Milano; Dipartimento di Ingegneria e Architettura 
      (S.M., M.P.), Universita degli Studi di Trieste, Italy; CINAC (G.F.), Hospital 
      Universitario HM Puerta del Sur, and Hospital Nacional de Paraplejicos, Toledo, 
      Spain; Department of Neurology (J.V.), University of Wurzburg, Germany; Division 
      of Neurosurgery (A.M.L.), University of Toronto, ON, Canada; Division of 
      Neurology (E.M.), Centre Hospitalier Universitaire de Grenoble, France; 
      Department of Medico-Surgical Sciences and Biotechnologies (F.C.), Sapienza 
      University Rome Polo Pontino, Rome; and "Aldo Ravelli" Research Center (A.P.), 
      Department of Health Sciences, University of Milan & Ospedale San Paolo, Milan, 
      Italy.
FAU - Prenassi, Marco
AU  - Prenassi M
AD  - From the Clinical Center for Neurotechnologies, Neuromodulation, and Movement 
      Disorders (M.A., S.M., F.C., T.B., F.C., P.R., S.B.), Fondazione IRCCS Ca'Granda 
      Ospedale Maggiore Policlinico, Milano; Dipartimento di Ingegneria e Architettura 
      (S.M., M.P.), Universita degli Studi di Trieste, Italy; CINAC (G.F.), Hospital 
      Universitario HM Puerta del Sur, and Hospital Nacional de Paraplejicos, Toledo, 
      Spain; Department of Neurology (J.V.), University of Wurzburg, Germany; Division 
      of Neurosurgery (A.M.L.), University of Toronto, ON, Canada; Division of 
      Neurology (E.M.), Centre Hospitalier Universitaire de Grenoble, France; 
      Department of Medico-Surgical Sciences and Biotechnologies (F.C.), Sapienza 
      University Rome Polo Pontino, Rome; and "Aldo Ravelli" Research Center (A.P.), 
      Department of Health Sciences, University of Milan & Ospedale San Paolo, Milan, 
      Italy.
FAU - Bocci, Tommaso
AU  - Bocci T
AD  - From the Clinical Center for Neurotechnologies, Neuromodulation, and Movement 
      Disorders (M.A., S.M., F.C., T.B., F.C., P.R., S.B.), Fondazione IRCCS Ca'Granda 
      Ospedale Maggiore Policlinico, Milano; Dipartimento di Ingegneria e Architettura 
      (S.M., M.P.), Universita degli Studi di Trieste, Italy; CINAC (G.F.), Hospital 
      Universitario HM Puerta del Sur, and Hospital Nacional de Paraplejicos, Toledo, 
      Spain; Department of Neurology (J.V.), University of Wurzburg, Germany; Division 
      of Neurosurgery (A.M.L.), University of Toronto, ON, Canada; Division of 
      Neurology (E.M.), Centre Hospitalier Universitaire de Grenoble, France; 
      Department of Medico-Surgical Sciences and Biotechnologies (F.C.), Sapienza 
      University Rome Polo Pontino, Rome; and "Aldo Ravelli" Research Center (A.P.), 
      Department of Health Sciences, University of Milan & Ospedale San Paolo, Milan, 
      Italy.
FAU - Cortese, Francesca
AU  - Cortese F
AD  - From the Clinical Center for Neurotechnologies, Neuromodulation, and Movement 
      Disorders (M.A., S.M., F.C., T.B., F.C., P.R., S.B.), Fondazione IRCCS Ca'Granda 
      Ospedale Maggiore Policlinico, Milano; Dipartimento di Ingegneria e Architettura 
      (S.M., M.P.), Universita degli Studi di Trieste, Italy; CINAC (G.F.), Hospital 
      Universitario HM Puerta del Sur, and Hospital Nacional de Paraplejicos, Toledo, 
      Spain; Department of Neurology (J.V.), University of Wurzburg, Germany; Division 
      of Neurosurgery (A.M.L.), University of Toronto, ON, Canada; Division of 
      Neurology (E.M.), Centre Hospitalier Universitaire de Grenoble, France; 
      Department of Medico-Surgical Sciences and Biotechnologies (F.C.), Sapienza 
      University Rome Polo Pontino, Rome; and "Aldo Ravelli" Research Center (A.P.), 
      Department of Health Sciences, University of Milan & Ospedale San Paolo, Milan, 
      Italy.
FAU - Rampini, Paolo
AU  - Rampini P
AD  - From the Clinical Center for Neurotechnologies, Neuromodulation, and Movement 
      Disorders (M.A., S.M., F.C., T.B., F.C., P.R., S.B.), Fondazione IRCCS Ca'Granda 
      Ospedale Maggiore Policlinico, Milano; Dipartimento di Ingegneria e Architettura 
      (S.M., M.P.), Universita degli Studi di Trieste, Italy; CINAC (G.F.), Hospital 
      Universitario HM Puerta del Sur, and Hospital Nacional de Paraplejicos, Toledo, 
      Spain; Department of Neurology (J.V.), University of Wurzburg, Germany; Division 
      of Neurosurgery (A.M.L.), University of Toronto, ON, Canada; Division of 
      Neurology (E.M.), Centre Hospitalier Universitaire de Grenoble, France; 
      Department of Medico-Surgical Sciences and Biotechnologies (F.C.), Sapienza 
      University Rome Polo Pontino, Rome; and "Aldo Ravelli" Research Center (A.P.), 
      Department of Health Sciences, University of Milan & Ospedale San Paolo, Milan, 
      Italy.
FAU - Barbieri, Sergio
AU  - Barbieri S
AD  - From the Clinical Center for Neurotechnologies, Neuromodulation, and Movement 
      Disorders (M.A., S.M., F.C., T.B., F.C., P.R., S.B.), Fondazione IRCCS Ca'Granda 
      Ospedale Maggiore Policlinico, Milano; Dipartimento di Ingegneria e Architettura 
      (S.M., M.P.), Universita degli Studi di Trieste, Italy; CINAC (G.F.), Hospital 
      Universitario HM Puerta del Sur, and Hospital Nacional de Paraplejicos, Toledo, 
      Spain; Department of Neurology (J.V.), University of Wurzburg, Germany; Division 
      of Neurosurgery (A.M.L.), University of Toronto, ON, Canada; Division of 
      Neurology (E.M.), Centre Hospitalier Universitaire de Grenoble, France; 
      Department of Medico-Surgical Sciences and Biotechnologies (F.C.), Sapienza 
      University Rome Polo Pontino, Rome; and "Aldo Ravelli" Research Center (A.P.), 
      Department of Health Sciences, University of Milan & Ospedale San Paolo, Milan, 
      Italy.
FAU - Priori, Alberto
AU  - Priori A
AD  - From the Clinical Center for Neurotechnologies, Neuromodulation, and Movement 
      Disorders (M.A., S.M., F.C., T.B., F.C., P.R., S.B.), Fondazione IRCCS Ca'Granda 
      Ospedale Maggiore Policlinico, Milano; Dipartimento di Ingegneria e Architettura 
      (S.M., M.P.), Universita degli Studi di Trieste, Italy; CINAC (G.F.), Hospital 
      Universitario HM Puerta del Sur, and Hospital Nacional de Paraplejicos, Toledo, 
      Spain; Department of Neurology (J.V.), University of Wurzburg, Germany; Division 
      of Neurosurgery (A.M.L.), University of Toronto, ON, Canada; Division of 
      Neurology (E.M.), Centre Hospitalier Universitaire de Grenoble, France; 
      Department of Medico-Surgical Sciences and Biotechnologies (F.C.), Sapienza 
      University Rome Polo Pontino, Rome; and "Aldo Ravelli" Research Center (A.P.), 
      Department of Health Sciences, University of Milan & Ospedale San Paolo, Milan, 
      Italy. alberto.priori@unimi.it.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20180214
PL  - United States
TA  - Neurology
JT  - Neurology
JID - 0401060
RN  - 0 (Antiparkinson Agents)
CIN - Neurology. 2018 Mar 13;90(11):497-498. PMID: 29444975
MH  - Aged
MH  - Antiparkinson Agents/therapeutic use
MH  - *Beta Rhythm
MH  - Deep Brain Stimulation/*methods
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Parkinson Disease/*physiopathology/*therapy
MH  - Subthalamic Nucleus/*physiopathology
MH  - Treatment Outcome
PMC - PMC5858949
EDAT- 2018/02/16 06:00
MHDA- 2019/08/06 06:00
PMCR- 2018/03/13
CRDT- 2018/02/16 06:00
PHST- 2017/08/04 00:00 [received]
PHST- 2017/12/20 00:00 [accepted]
PHST- 2018/02/16 06:00 [pubmed]
PHST- 2019/08/06 06:00 [medline]
PHST- 2018/02/16 06:00 [entrez]
PHST- 2018/03/13 00:00 [pmc-release]
AID - WNL.0000000000005121 [pii]
AID - NEUROLOGY2017840827 [pii]
AID - 10.1212/WNL.0000000000005121 [doi]
PST - ppublish
SO  - Neurology. 2018 Mar 13;90(11):e971-e976. doi: 10.1212/WNL.0000000000005121. Epub 
      2018 Feb 14.