Long-term Outcomes of Remote vs In-Clinic Deep Brain Stimulation Programming
Overview
This multicenter study evaluated the long-term clinical outcomes of remote digital deep brain stimulation (DBS) programming compared to standard in-clinic care in Parkinson’s disease patients. Results at 6 and 12 months demonstrated sustained clinical improvements, quality of life enhancements, and comparable safety profiles across both care models, supporting the scalability of remote DBS programming.
Background
Deep brain stimulation is an established treatment for motor symptoms in Parkinson’s disease, requiring individualized programming and specialist follow-up. Access to these services is often limited by geographic and logistical barriers. Digital health interventions, including remote DBS programming via virtual clinics, offer potential solutions to improve accessibility and personalization of care. However, long-term effectiveness and safety data in real-world settings remain limited.
Data Highlights
Outcome Measure
In-Clinic Group
Virtual Clinic Group
Patient Global Impression of Change (PGI-C)
2.3 ± 1.4
2.8 ± 1.3
Clinician Global Impression of Change (CGI-C)
1.8 ± 1.1
2.2 ± 0.9
PGI Severity Score (baseline to 12 mo)
5.1 to 3.5 ± 1.6
5.1 to 3.9 ± 1.3
CGI Severity Score (baseline to 12 mo)
5.3 ± 0.9 to 3.4 ± 1.3
5.5 ± 0.8 to 3.5 ± 1.2
PDQ-39 Summary Index Change
–4.3 ± 12.5
–5.9 ± 13.1
MDS-UPDRS Part III at 12 mo
15.3 ± 14.3
15.5 ± 9.4
Levodopa Equivalent Dose (LED) Change
+99.1 ± 315.8 mg
–64.8 ± 265.8 mg
Key Findings
Both remote and in-clinic DBS programming groups showed sustained improvements in patient- and clinician-reported global impressions of change at 6 and 12 months.
Symptom severity scores decreased comparably in both groups, indicating effective motor symptom management.
Quality of life, measured by PDQ-39, improved significantly from baseline with no difference between groups.
Motor function assessed by MDS-UPDRS Part III improved similarly in both groups at 12 months.
Levodopa equivalent dose tended to decrease in the remote programming group and slightly increased in the in-clinic group, though variability was high.
No significant differences in safety or adverse events were observed between remote and in-clinic care models.
Clinical Implications
Remote DBS programming via virtual clinics provides a clinically effective and safe complement to traditional in-clinic care, enabling broader access without compromising long-term outcomes. Clinicians can consider integrating remote programming into routine management to reduce patient travel burden and enhance personalized care delivery. Continued multidisciplinary management remains essential alongside remote DBS programming.
Conclusion
This study confirms that remote digital DBS programming achieves long-term clinical outcomes equivalent to standard in-clinic care, supporting its use as a scalable and sustainable model in real-world Parkinson’s disease management.
References
Study Authors/Multicenter Evaluation/2024 -- Multicenter Evaluation of Long-term Clinical Outcomes Following Digital Deep Brain Stimulation in Real-world Settings
by Alireza Gharabaghi, Sergiu Groppa, Elena Casas, Alfons Schnitzler, Laura Muñoz-Delgado, Vicky L. Marshall, Jessica Karl, Lin Zhang, Ramiro Alvarez, Mary S. Feldman, Michael J. Soileau, Lan Luo, Benjamin L. Walter, Chengyuan Wu, Hong Lei, Damian M. Herz, Devyani Nanduri, Claudia A. Salazar, Corneliu Luca, Daniel Weiss
