Wan Xiaonan, Duan Chengcheng, Lin Zhengyu, Zeng Zhitong, Zhang Chencheng, Li Dianyou
Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
Clinical Neuroscience Center, Ruijin Hospital Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Neurol. 2024 Jun 19;15:1398929. doi: 10.3389/fneur.2024.1398929. eCollection 2024.
Remote programming (RP) is an emerging technology that enables the adjustment of implantable pulse generators (IPGs) via the Internet for people with Parkinson's disease (PwPD) who have undergone deep brain stimulation (DBS). Previous studies have not comprehensively explored the effectiveness of RP in managing motor symptoms, often omitting assessments such as the rigidity and retropulsion tests during the follow-up. This study evaluates the comprehensive improvements in motor performance and the potential cost benefits of RP for PwPD with DBS.
A retrospective analysis was conducted on two groups of patients-those who received RP and those who received standard programming (SP). Clinical outcomes including motor improvement, quality of life, and daily levodopa dosage were compared between the groups during a 12 (± 3)-month in-clinic follow-up.
A total of 44 patients were included in the study, with 18 in the RP group and 26 in the SP group. No significant differences were observed in the frequency of programming sessions or clinical outcomes between the groups (p > 0.05). However, the RP group experienced significantly lower costs per programming session than the SP group ( < 0.05), despite patients in the former group living further from our center ( < 0.05).
Our findings suggest that RP could significantly reduce the costs of programming for PwPD with DBS, especially without compromising the effectiveness of treatment across all motor symptoms in the short term.
远程编程(RP)是一项新兴技术,可通过互联网对接受过深部脑刺激(DBS)的帕金森病患者(PwPD)的植入式脉冲发生器(IPG)进行调整。以往研究尚未全面探讨RP在管理运动症状方面的有效性,在随访过程中常常忽略诸如强直和后推试验等评估。本研究评估了RP对接受DBS的PwPD患者运动性能的全面改善情况以及潜在的成本效益。
对两组患者进行回顾性分析,一组接受RP,另一组接受标准编程(SP)。在为期12(±3)个月的门诊随访期间,比较两组患者的临床结局,包括运动改善情况、生活质量和每日左旋多巴剂量。
本研究共纳入44例患者,其中RP组18例,SP组26例。两组之间在编程次数或临床结局方面未观察到显著差异(p>0.05)。然而,尽管RP组患者居住地离我们中心更远(p<0.05),但该组每次编程的成本显著低于SP组(p<0.05)。
我们的研究结果表明,RP可以显著降低接受DBS的PwPD患者的编程成本,尤其是在短期内不影响所有运动症状的治疗效果的情况下。