Three-Year Follow-Up of a Prospective, Double Blinded Multi-Center RCT Evaluating DBS with a Multiple Source, Constant-Current Rechargeable System for Treatment of Parkinson's Disease (INTREPID). (16th November 2020)

• Record Type: Journal Article
• Authors: Starr, Philip A; Tröster, Alexander; Schrock, Lauren; House, Paul A; Giroux, Monique; Hebb, Adam O; Farris, Sierra; Whiting, Donald M; Lechliter, Timothy; Ostrem, Jill L; Palenzuela, Marta S.L; Galifianakis, Nicholas; Metman, Leo V; Sani, Sepehr; Karl, Jessica; Siddiqui, Mustafa; Tatter, Stephen B; ul Haq, Ihtsham; Machado, Andre; Gostkowski, Michal; Tagliati, Michele; Mamelak, Adam N; Okun, Michael S; Foote, Kelly D; Moguel-Cobos, Guillermo; Ponce, Francisco A; Pahwa, Rajesh; Nazzaro, Jules M; Buetefisch, Cathrin; Gross, Robert E; Luca, Corneliu; Jagid, Jonathan R; Revuelta, Gonzalo; Takacs, Istvan; Pourfar, Michael; Mogilner, Alon Y; Duker, Andy; Mandybur, George T; Rosenow, Joshua M; Cooper, Scott; Park, Michael; Khandhar, Suketu; Sedrak, Mark; Pilitsis, Julie G; Phibbs, Fenna; Uitti, Ryan J; Chen, Lilly; Roshini, Jain; Vitek, Jerrold L;
• Is Part Of: Neurosurgery. Volume 67(2010)Supplement 1
• Publication Date: 2020-11-16
• Subjects: Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1093/neuros/nyaa447_614
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract: INTRODUCTION: Subthalamic Deep Brain Stimulation (STN-DBS) is an established therapeutic option for managing the motor symptoms of Parkinson's disease (PD); however, it has not been previously evaluated in a double-blind, randomized controlled trial (RCT) with sham control. METHODS: INTREPID (Clinicaltrials.gov identifier: NCT01839396) is a multi-center, prospective, double-blinded randomized controlled trial (RCT) sponsored by Boston Scientific. Subjects with advanced PD were implanted bilaterally in the STN with a multiple-source, constant-current DBS system (Vercise, Boston Scientific). Subjects were randomized to either receive active versus control settings for 12 weeks. Upon completion of the 12-week blinded period, subjects received their best therapeutic settings in the open-label phase up to 5 years. During long-term follow-up, motor improvement and quality of life was evaluated using UPRDS, PDQ39, Schwann and England, etc. Adverse events were also collected. RESULTS: The study met the primary endpoint demonstrated by a mean difference of 3.03 ± 4.52 hours (p < 0.001) between active and control groups in ON time without troublesome dyskinesia and with no increase in antiparkisonian medication, from post-implant baseline to 12-weeks post-randomization. At 2 years, a 46% improvement in UPDRS III scores was reported (sustained since last follow-up at 1 year) and overall improvement in quality of life was maintained compared to pre-surgery screening. Three-year follow up data will be presented. CONCLUSION: Results of the INTREPID RCT demonstrate that use of a multiple-source, constant current DBS system is safe and effective for treatment of PD motor symptoms. Long-term follow up on the use of this system and associated outcomes will be presented.