Jergas Hannah, Steffen Julia K, Schedlich-Teufer Charlotte, Strelow Joshua N, Kramme Johanna, Fink Gereon R, Visser-Vandewalle Veerle, Barbe Michael T, Wirths Jochen
Department of Neurology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50924 Cologne, Germany.
Department of Functional Neurosurgery and Stereotaxy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50924 Cologne, Germany.
Brain Sci. 2024 Sep 11;14(9):914. doi: 10.3390/brainsci14090914.
Deep brain stimulation (DBS) for Parkinson's disease (PD) often necessitates frequent clinic visits for stimulation program optimization, with limited experience in remote patient management. Due to the resource-intensive nature of these procedures, we investigated a way to simplify stimulation optimization for these patients that allows for the continuous monitoring of symptoms while also reducing patient burden and travel distances. To this end, we prospectively recruited ten patients treated with DBS for PD to evaluate the feasibility of telemedicinal optimization in a home-based setting. Patients recorded daily videos of a modified Unified Parkinson's Disease Rating Scale (UPDRS) III, which experienced DBS physicians located at the clinic assessed to provide instructions on adjusting stimulation settings using a handheld programmer with previously set programs as well as patient amplitude control. This study concluded with significant improvements in participants' motor status as measured by the UPDRS-III ( = 0.0313) compared to baseline values. These findings suggest that remote video-guided optimization of DBS settings is feasible and may enhance motor outcomes for patients.
用于帕金森病（PD）的深部脑刺激（DBS）通常需要患者频繁前往诊所进行刺激程序优化，而远程患者管理方面的经验有限。由于这些程序资源密集的特性，我们研究了一种简化这些患者刺激优化的方法，该方法能够持续监测症状，同时减轻患者负担并缩短出行距离。为此，我们前瞻性地招募了10名接受DBS治疗的帕金森病患者，以评估在家中进行远程医疗优化的可行性。患者每天录制改良版统一帕金森病评定量表（UPDRS）第三部分的视频，诊所经验丰富的DBS医生通过这些视频进行评估，以便使用预先设置好程序的手持编程器以及患者振幅控制来提供调整刺激设置的指导。与基线值相比，本研究得出结论，参与者的运动状态通过UPDRS-III测量有显著改善（P = 0.0313）。这些发现表明，远程视频指导的DBS设置优化是可行的，并且可能改善患者的运动结果。
