Parkinson’s Disease (PD) Patient Experience with the ClearPoint(TM) Interventional MRI (iMRI)-Guided Method for Placement of Deep Brain Stimulation (DBS) Leads (P6.085)

OBJECTIVE: To assess patient experience with ClearPoint(TM) interventional MRI (iMRI)-guided implantation of DBS leads in PD. BACKGROUND: The traditional stereotactic approach for DBS lead placement requires patients to be awake for the procedure, which may be poorly tolerated in some patients. The iMRI technique uses real-time image guidance to place DBS leads, obviating the need for patients to be awake. We explored the iMRI surgical experience to better understand the patient’s perspective with this technique. DESIGN/METHODS: All English-speaking PD patients undergoing iMRI DBS between 2010-2014 were invited to participate in the study. Subjects completed a structured telephone survey exploring their preoperative preferences, as well as intra-, and post-operative experiences. Baseline demographics and pre-operative PD symptom burden data were collected. RESULTS: 70 patients were screened and 32 patients (26M/6F) completed the study [baseline mean age: 63 ± 7 years, duration of disease: 12.5 ± 5 years, UPDRS-III off score: 40 ± 12, Beck Anxiety Inventory (BAI): 13 ± 7; Beck Depression Inventory (BDI-II): 11 ± 6]. The most common reasons to prefer iMRI over stereotactic DBS surgery, in order of importance, included: ability to be asleep during surgery, absence of stereotactic head-frame placement, and ability to take usual PD medications on the day-of surgery. There was no correlation between pre-op BAI and BDI-II scores and degree of anxiety on the day-of surgery (Likert scale 0-3, r = 0.28 and r = 0.18, respectively). Ninety-four percent of patients felt they made the correct decision to undergo iMRI implantation over the traditional stereotactic approach. CONCLUSIONS: Patients undergoing iMRI DBS surgery had an overall positive experience. The decision to choose this technique was driven primarily by concern about being potentially uncomfortable during awake neurosurgery. Future studies should include similar evaluation of frame-based cases. Study Supported by: Not applicable. Disclosure: Dr. LaHue has nothing to disclose. Dr. Katz has received personal compensation for activities with Medtronic. Dr. Galifianakis has nothing to disclose. Dr. San Luciano has received personal compensation for activities with Merz Pharma as a consultant. Dr. Ziman has nothing to disclose. Dr. Wang has nothing to disclose. Dr. Racine has received personal compensation for activities with Novartis as a consultant. Dr. Starr has received personal compensation for activities with Boston Scientific Corporation as a consultant. Dr. Larson has received personal compensation for activities with Medtronic as a consultant. Dr. Ostrem has received personal compensation for activities with Allergan, Inc. as a speaker. Dr. Ostrem has received research support from MRI Interventions, Inc., St. Jude Medical, and Boston Scientific Corporation.