title: A method for predicting the outcomes of combined pharmacologic and deep brain stimulation therapy for Parkinson's disease.
abstract: Deep brain stimulation (DBS) is an established therapy for the management of advanced Parkinson's disease (PD). However, the coupled adjustment of pharmacologic therapy and stimulation parameter settings is a time-consuming process and treatment outcomes are not always optimal. In this study, we develop a linear function that relates the DBS parameters, the levodopa dosage, and patient-specific preoperative clinical data with the actual treatment motor outcomes. To this end, we incorporate image-based patient-specific computer models of the volume of tissue activated by DBS in a multilinear regression analysis (6 PD patients; 60 follow up visits). The resulting predictor function was highly correlated with the actual motor outcomes (r = 0.76; p < 0.05). These results demonstrate that the outcomes of a combined pharmacologic-DBS therapy can be predicted and may facilitate patient-specific treatment optimization for maximal benefits and minimal adverse effects.
authors.forename: Reuben R
authors.initials: RR
authors.lastname: Shamir
authors.forename: Trygve
authors.initials: T
authors.lastname: Dolbert
authors.forename: Angela M
authors.initials: AM
authors.lastname: Noecker
authors.forename: Anneke M
authors.initials: AM
authors.lastname: Frankemolle
authors.forename: Benjamin L
authors.initials: BL
authors.lastname: Walter
authors.forename: Cameron C
authors.initials: CC
authors.lastname: McIntyre
mesh_terms: D000368:Aged; D000978:Antiparkinson Agents / Q000008:administration & dosage; D001921:Brain / Q000187:drug effects / Q000473:pathology*; D003131:Combined Modality Therapy / Q000379:methods; D046690:Deep Brain Stimulation / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods; D007980:Levodopa / Q000008:administration & dosage*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods; D010300:Parkinson Disease / Q000175:diagnosis* / Q000628:therapy*; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa