Accelerated symptom improvement in Parkinson’s disease via remote internet-based optimization of deep brain stimulation therapy: a randomized controlled multicenter trial
Abstract Background Deep brain stimulation (DBS) has emerged as an important therapeutic intervention for neurological and neuropsychiatric disorders. After initial programming, clinicians are tasked with fine-tuning DBS parameters through repeated in-person clinic visits. We aimed to evaluate wheth...
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Nature Portfolio
2025-01-01
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| Series: | Communications Medicine |
| Online Access: | https://doi.org/10.1038/s43856-025-00744-7 |
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| author | Alireza Gharabaghi Sergiu Groppa Marta Navas-Garcia Alfons Schnitzler Laura Muñoz-Delgado Vicky L. Marshall Jessica Karl Lin Zhang Ramiro Alvarez Mary S. Feldman Michael J. Soileau Lan Luo S. Elizabeth Zauber Benjamin L. Walter Chengyuan Wu Hong Lei Damian M. Herz Ming-Hua Chung Yagna Pathak Bram Blomme Binith Cheeran Corneliu Luca Daniel Weiss |
| author_facet | Alireza Gharabaghi Sergiu Groppa Marta Navas-Garcia Alfons Schnitzler Laura Muñoz-Delgado Vicky L. Marshall Jessica Karl Lin Zhang Ramiro Alvarez Mary S. Feldman Michael J. Soileau Lan Luo S. Elizabeth Zauber Benjamin L. Walter Chengyuan Wu Hong Lei Damian M. Herz Ming-Hua Chung Yagna Pathak Bram Blomme Binith Cheeran Corneliu Luca Daniel Weiss |
| author_sort | Alireza Gharabaghi |
| collection | DOAJ |
| description | Abstract Background Deep brain stimulation (DBS) has emerged as an important therapeutic intervention for neurological and neuropsychiatric disorders. After initial programming, clinicians are tasked with fine-tuning DBS parameters through repeated in-person clinic visits. We aimed to evaluate whether DBS patients achieve clinical benefit more rapidly by incorporating remote internet-based adjustment (RIBA) of stimulation parameters into the continuum of care. Methods We conducted a randomized controlled multicenter study (ClinicalTrails.gov NCT05269862) involving patients scheduled for de novo implantation with a DBS System to treat Parkinson’s Disease. Eligibility criteria included the ability to incorporate RIBA as part of routine follow-up care. Ninety-six patients were randomly assigned in a 1:1 ratio using automated allocation, blocked into groups of 4, allocation concealed, and no stratification. After surgery and initial configuration of stimulation parameters, optimization of DBS settings occurred in the clinic alone (IC) or with additional access to RIBA. The primary outcome assessed differences in the average time to achieve a one-point improvement on the Patient Global Impression of Change score between groups. Patients, caregivers, and outcome assessors were not blinded to group assignment. Most of the data collection took place in the patient’s home environment. Results Access to RIBA reduces the time to symptom improvement, with patients reporting 15.1 days faster clinical benefit (after 39.1 (SD 3.3) days in the RIBA group (n = 48) and after 54.2 (SD 3.7) days in the IC group (n = 48)). None of the reported adverse events are related to RIBA. Conclusions This study demonstrates safety and efficacy of internet-based adjustment of DBS therapy, while providing clinical benefit earlier than in-clinic optimization of stimulation parameters by increasing patient access to therapy adjustment. |
| format | Article |
| id | doaj-art-0c98686a117b4002ba0dc54ab75de3f3 |
| institution | Kabale University |
| issn | 2730-664X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Communications Medicine |
| spelling | doaj-art-0c98686a117b4002ba0dc54ab75de3f32025-02-02T12:40:09ZengNature PortfolioCommunications Medicine2730-664X2025-01-015111210.1038/s43856-025-00744-7Accelerated symptom improvement in Parkinson’s disease via remote internet-based optimization of deep brain stimulation therapy: a randomized controlled multicenter trialAlireza Gharabaghi0Sergiu Groppa1Marta Navas-Garcia2Alfons Schnitzler3Laura Muñoz-Delgado4Vicky L. Marshall5Jessica Karl6Lin Zhang7Ramiro Alvarez8Mary S. Feldman9Michael J. Soileau10Lan Luo11S. Elizabeth Zauber12Benjamin L. Walter13Chengyuan Wu14Hong Lei15Damian M. Herz16Ming-Hua Chung17Yagna Pathak18Bram Blomme19Binith Cheeran20Corneliu Luca21Daniel Weiss22Institute for Neuromodulation and Neurotechnology, University Hospital Tübingen (UKT), Faculty of Medicine, University TübingenMovement Disorders and Neurostimulation, Biomedical Statistics and Multimodal Signal Processing Unit, Department of Neurology, University Medical Center of the Johannes Gutenberg UniversityNeurosurgery Department, La Princesa University HospitalDepartment of Neurology, and Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine University DüsseldorfUnidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de SevillaDepartment of Neurology, Institute of Neurological Sciences, Queen Elizabeth University HospitalDepartment of Neurological Sciences, Rush UniversityDepartment of Neurology, University of California, DavisUnidad de Enfermedades Neurodegenerativas, Departamento de Neurociencias, Servicio de Neurologia, Hospital Universitari Germans Trias I PujolNeurology, Dartmouth-Hitchcock Medical CenterTexas Movement Disorder Specialists, PLLCDepartment of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical SchoolNeurology, Indiana University School of MedicineCenter for Neurological Restoration, Cleveland ClinicDepartment of Neurological Surgery, Thomas Jefferson UniversityDepartment of Neurology, University of ArizonaMovement Disorders and Neurostimulation, Biomedical Statistics and Multimodal Signal Processing Unit, Department of Neurology, University Medical Center of the Johannes Gutenberg UniversityAbbott NeuromodulationAbbott NeuromodulationAbbott NeuromodulationAbbott NeuromodulationDepartment of Neurology, University of MiamiCenter for Neurology, Department of Neurodegenerative Diseases, and Hertie Institute for Clinical Brain Research, University TübingenAbstract Background Deep brain stimulation (DBS) has emerged as an important therapeutic intervention for neurological and neuropsychiatric disorders. After initial programming, clinicians are tasked with fine-tuning DBS parameters through repeated in-person clinic visits. We aimed to evaluate whether DBS patients achieve clinical benefit more rapidly by incorporating remote internet-based adjustment (RIBA) of stimulation parameters into the continuum of care. Methods We conducted a randomized controlled multicenter study (ClinicalTrails.gov NCT05269862) involving patients scheduled for de novo implantation with a DBS System to treat Parkinson’s Disease. Eligibility criteria included the ability to incorporate RIBA as part of routine follow-up care. Ninety-six patients were randomly assigned in a 1:1 ratio using automated allocation, blocked into groups of 4, allocation concealed, and no stratification. After surgery and initial configuration of stimulation parameters, optimization of DBS settings occurred in the clinic alone (IC) or with additional access to RIBA. The primary outcome assessed differences in the average time to achieve a one-point improvement on the Patient Global Impression of Change score between groups. Patients, caregivers, and outcome assessors were not blinded to group assignment. Most of the data collection took place in the patient’s home environment. Results Access to RIBA reduces the time to symptom improvement, with patients reporting 15.1 days faster clinical benefit (after 39.1 (SD 3.3) days in the RIBA group (n = 48) and after 54.2 (SD 3.7) days in the IC group (n = 48)). None of the reported adverse events are related to RIBA. Conclusions This study demonstrates safety and efficacy of internet-based adjustment of DBS therapy, while providing clinical benefit earlier than in-clinic optimization of stimulation parameters by increasing patient access to therapy adjustment.https://doi.org/10.1038/s43856-025-00744-7 |
| spellingShingle | Alireza Gharabaghi Sergiu Groppa Marta Navas-Garcia Alfons Schnitzler Laura Muñoz-Delgado Vicky L. Marshall Jessica Karl Lin Zhang Ramiro Alvarez Mary S. Feldman Michael J. Soileau Lan Luo S. Elizabeth Zauber Benjamin L. Walter Chengyuan Wu Hong Lei Damian M. Herz Ming-Hua Chung Yagna Pathak Bram Blomme Binith Cheeran Corneliu Luca Daniel Weiss Accelerated symptom improvement in Parkinson’s disease via remote internet-based optimization of deep brain stimulation therapy: a randomized controlled multicenter trial Communications Medicine |
| title | Accelerated symptom improvement in Parkinson’s disease via remote internet-based optimization of deep brain stimulation therapy: a randomized controlled multicenter trial |
| title_full | Accelerated symptom improvement in Parkinson’s disease via remote internet-based optimization of deep brain stimulation therapy: a randomized controlled multicenter trial |
| title_fullStr | Accelerated symptom improvement in Parkinson’s disease via remote internet-based optimization of deep brain stimulation therapy: a randomized controlled multicenter trial |
| title_full_unstemmed | Accelerated symptom improvement in Parkinson’s disease via remote internet-based optimization of deep brain stimulation therapy: a randomized controlled multicenter trial |
| title_short | Accelerated symptom improvement in Parkinson’s disease via remote internet-based optimization of deep brain stimulation therapy: a randomized controlled multicenter trial |
| title_sort | accelerated symptom improvement in parkinson s disease via remote internet based optimization of deep brain stimulation therapy a randomized controlled multicenter trial |
| url | https://doi.org/10.1038/s43856-025-00744-7 |
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