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Directional DBS superior to omnidirectional DBS

Directional deep brain stimulation (DBS) in Parkinson’s disease (PD) yielded a wider therapeutic window and a lower therapeutic current strength than conventional omnidirectional DBS in the prospective blinded crossover PROGRESS study [1]. Directional DBS was also preferred by subjects.

Patients receiving subthalamic nucleus DBS for PD received omnidirectional stimulation for 3 months, followed by directional stimulation for another 3 months. Superiority of directional stimulation required a wider therapeutic window in >60% of patients after 3 months (primary endpoint). For non-inferiority of directional stimulation, this percentage was set at 40% (secondary endpoint).

A directional DBS system was implanted in 234 subjects, without intracranial haemorrhages or infections occurring. There were 13 serious adverse events in 12 patients (5.1%). Using directional stimulation, the therapeutic w...

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