ORIGINAL RESEARCH article
Front. Neurol.
Sec. Movement Disorders
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1618480
This article is part of the Research TopicDeep Brain Stimulation: Pioneering Strategies for Improving Functional Performance and Mitigating Aggressiveness in Patients with Neurodevelopmental DisordersView all articles
Image-guided optimization of current steering in STN-DBS for Parkinson's disease
Provisionally accepted
- 1Juntendo University, Bunkyō, Japan
- 2Ookuma Hospital, Nagoya, Aichi, Japan
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Objective: Recent advancements in multiple independent current control (MICC) technology, combined with directional leads, have improved clinical outcomes in subthalamic nucleus deep brain stimulation (STN-DBS) for Parkinson's disease (PD). However, these advancements have also increased the complexity and duration of programming. This study aimed to evaluate the clinical utility of image-guided programming (IGP) in patients with stable postoperative symptoms.Methods: Sixteen patients with advanced PD, who had undergone STN-DBS and exhibited stable symptoms for at least six months under conventional programming, were enrolled. An alternative stimulation program was developed using Stimview™ XT, a patient-specific image-guided interface, without altering pulse width or frequency. Stimulation fields were modified using horizontal and vertical current steering based on individual STN anatomy. Motor function was evaluated via the Unified Parkinson's Disease Rating Scale part III (UPDRS III) before, one hour after, and three months post-reprogramming.Results: Image-guided current steering resulted in modifications in 29 of the 32 leads. Horizontal steering was newly introduced in 23 leads, while vertical adjustments were made in 6 leads. Nine patients reported immediate subjective improvement, and 15 of 16 opted to continue with the IGPderived settings. Statistically significant improvements in Unified Parkinson's Disease Rating Scale (UPDRS) part III scores were observed one hour after reprogramming (p < 0.05), and these improvements were sustained at the three-month follow-up.Conclusions: IGP provides a clinically effective, time-efficient strategy for refining current steering in STN-DBS, even in patients with stable symptoms under conventional settings. By leveraging individualized anatomical visualization, IGP enhances precision in targeting the dorsolateral STN, resulting in improved motor outcomes.
Keywords: Parkinson's disease, Subthalamic Nucleus, Deep Brain Stimulation, Current steering, image-guided programming
Received: 26 Apr 2025; Accepted: 09 Jun 2025.
Copyright: © 2025 Umemura, Mizuno, Maki and Masago. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Atsushi Umemura, Juntendo University, Bunkyō, Japan
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