Self-adjustment of deep brain stimulation delays optimization in Parkinson's disease

Background: Parkinson's Disease patients undergo time-consuming programming to refine stimulation parameters after deep brain stimulation surgery. Objective: To assess whether the use of the advanced functions of a patient's programmer would facil-itate programming of deep brain stimulation. Methods: Thirty patients were randomly allocated to the use of advanced versus simple mode of the patient programmer in this single-centre, prospective, randomized, controlled study. Primary outcome was the number of days required to optimize the stimulation settings. Results: The number of days required to optimize stimulation was significantly lower in the simple mode (88.5 +/- 33.1 vs. 142.1 +/- 67.4, p = 0.01). In addition, the advanced mode group had a higher number of side effects (5.4 +/- 3.1 vs. 2.6 +/- 1.9, p = 0.0055). Conclusions: The use of the advanced functions of patient programmer delays programming optimiza-tion and it is associated with a higher number of side effects. These findings highlight the need for other methods for faster and safer stimulation programming. (c) 2021 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).