title: Model-Based Deep Brain Stimulation Programming for Parkinson's Disease: The GUIDE Pilot Study.
abstract: BACKGROUND
  Achieving optimal results following deep brain stimulation (DBS) typically involves several months of programming sessions. The Graphical User Interface for DBS Evaluation (GUIDE) study explored whether a visual programming system could help clinicians accurately predetermine ideal stimulation settings in DBS patients with Parkinson's disease.
  
  
  METHODS
  A multicenter prospective, observational study was designed that utilized a blinded Unified Parkinson's Disease Rating Scale (UPDRS)-III examination to prospectively assess whether DBS settings derived using a neuroanatomically based computer model (Model) could provide comparable efficacy to those determined through traditional, monopolar review-based programming (Clinical). We retrospectively compared the neuroanatomical regions of stimulation, power consumption and time spent on programming using both methods.
  
  
  RESULTS
  The average improvement in UPDRS-III scores was 10.4 ± 7.8 for the Model settings and 11.7 ± 8.7 for the Clinical settings. The difference between the mean UPDRS-III scores with the Model versus the Clinical settings was 0.26 and not statistically significant (p = 0.9866). Power consumption for the Model settings was 48.7 ± 22 μW versus 76.1 ± 46.5 μW for the Clinical settings. The mean time spent programming using the Model approach was 31 ± 16 s versus 41.4 ± 29.1 min using the Clinical approach.
  
  
  CONCLUSIONS
  The Model-based DBS settings provided similar benefit to the Clinical settings based on UPDRS-III scores and were often arrived at in less time and required less power than the Clinical settings.
authors.affiliation: Department of Neurosurgery, Center for Neuromodulation, NYU Langone Medical Center, New York, N.Y., USA.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Pourfar
authors.forename: Alon Y
authors.initials: AY
authors.lastname: Mogilner
authors.forename: Sierra
authors.initials: S
authors.lastname: Farris
authors.forename: Monique
authors.initials: M
authors.lastname: Giroux
authors.forename: Maria
authors.initials: M
authors.lastname: Gillego
authors.forename: Yufan
authors.initials: Y
authors.lastname: Zhao
authors.forename: David
authors.initials: D
authors.lastname: Blum
authors.forename: Hemant
authors.initials: H
authors.lastname: Bokil
authors.forename: Mark C
authors.initials: MC
authors.lastname: Pierre
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D046690:Deep Brain Stimulation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008959:Models, Neurological; D010300:Parkinson Disease / Q000628:therapy*; D010865:Pilot Projects; D011446:Prospective Studies; D012984:Software; D020531:Subthalamic Nucleus / Q000503:physiopathology*; D013813:Therapy, Computer-Assisted / Q000379:methods*