Table 2 Five-point Likert questionnaire with the results (median ± IQR) for each round
Statement | 1st round (n = 19; RR = 90.5%) | 2nd round (n = 20; RR = 95.2%) | 3rd round (n = 20; RR = 95.2%) |
|---|---|---|---|
Technical aspects of adaptive DBS | |||
S1. Adaptive DBS is at the beginning of its clinical applications, but I think that there may still be technological limitations | 4 ± 1 | 4 ± 0.25 | 4 ± 0—C.R. |
S2. I think that a possible limitation of the diffusion of adaptive DBS are high costs | 3 ± 1 | 3 ± 1.25 | 3 ± 1 |
S3. I think adaptive DBS is applicable in patients with not well-positioned electrodes | 1 ± 1 | 1 ± 1 | 1 ± 0—C.R. |
S4. I think adaptive DBS is applicable when one side only is able to record | 3 ± 1 | 4 ± 1 | 4 ± 1 |
S5. I think that only modulating the amplitude might be a limiting factor of adaptive DBS | 3 ± 2 | 2 ± 2 | 2.5 ± 2 |
S6. I think an actual risk for adaptive DBS is overstimulation | 3 ± 1 | 3 ± 1 | 3 ± 0 |
S7. I think an actual risk for adaptive DBS is under stimulation | 3 ± 1.5 | 3 ± 1 | 3 ± 1 |
S8. I think adaptive DBS requires high level of expertise | 4 ± 1 | 5 ± 1 | 5 ± 0—C.R. |
S9. I think adaptive DBS is feasible only in experienced DBS centres with neurophysiological expertise | 4 ± 1.5 | 4 ± 0.25 | 4 ± 0 |
S10. I think adaptive DBS surgery is time-consuming | 3 ± 2 | 4 ± 2 | 4 ± 2 |
S11. I think adaptive DBS programming is time-consuming | 4 ± 3 | 4 ± 1 | 4 ± 1 |
S12. I think that automatic programming will reduce programming time | 5 ± 1 | 5 ± 1 | 5 ± 1 |
S13. I think that automatic programming is safe as long as the neurologist can set upper and lower limits for stimulation intensity | 4 ± 0 | 4 ± 0—C.R. | – |
S14. I think fast adaptation adaptive DBS methods are superior to slow adaptation adaptive DBS methods | 3 ± 1 | 3 ± 0 | 3 ± 0—C.R. |
S15. I think slow adaptation adaptive DBS methods are superior to fast adaptation adaptive DBS methods | 3 ± 1 | 3 ± 0 | 3 ± 0—C.R. |
S16. I think adaptive DBS will be based more likely on feedback from wearables than on signal recording from the DBS electrodes | 2 ± 1 | 2 ± 0 | 2 ± 0.25 |
S17. I think adaptive DBS will be based more likely on signal recording from the DBS electrodes than on feedback from wearables | 4 ± 1 | 4 ± 1 | 4 ± 0 |
S18. I think adaptive DBS would help to diffuse DBS with segmented electrodes | 3 ± 1 | 3 ± 0 | 3 ± 0—C.R. |
S19. I think the rapid development of artificial intelligence (AI) will fuel the clinical use of adaptive DBS | 4 ± 1 | 4 ± 1 | 4 ± 0.25 |
S20. I think current pacemaker technology in principle allows to install adaptive DBS algorithms | 4 ± 0.5 | 4 ± 0.25 | 4 ± 0—C.R. |
S21. I think changes in technology are still necessary to foster adaptive DBS soon | 4 ± 1 | 4 ± 1 | 5 ± 1 |
Clinical aspects of adaptive DBS | |||
S22. I think adaptive DBS will be clinical routine in 10 years from now | 4 ± 0 | 4 ± 1 | 4 ± 0—C.R. |
S23. I think adaptive DBS will be clinical routine in 5 years from now | 3 ± 1.5 | 3 ± 1 | 3 ± 1 |
S24. The side effects (ramping) will lead to many patients being unable to tolerate adaptive DBS | 2 ± 1 | 2.5 ± 1 | 2.5 ± 1 |
S25. I think adaptive DBS is a safe technology | 4 ± 0.5 | 4 ± 0 | 4 ± 0—C.R. |
S26. I think adaptive DBS is applicable on a large scale | 3 ± 1 | 3 ± 1 | 3 ± 1 |
S27. I think adaptive DBS is applicable only for non-tremor patients with Parkinson’s disease | 2 ± 1 | 2 ± 0.25 | 2 ± 1 |
S28. I think adaptive DBS is applicable also for tremor-dominant patients with Parkinson’s disease | 4 ± 0.5 | 4 ± 0—C.R. | – |
S29. I think the primary clinical indication for adaptive DBS will rather be tremor then Parkinson’s disease | 2 ± 1 | 2 ± 1 | 2 ± 0 |
S30. I think the patient profile who will likely benefit from adaptive DBS is the patient with significant motor fluctuations before DBS | 4 ± 1.5 | 4 ± 1.25 | 4 ± 0—C.R. |
S31. I think the patient profile who will likely benefit from adaptive DBS is the patient with significant motor fluctuations on conventional DBS | 4 ± 0 | 4 ± 0 | 4 ± 0—C.R. |
S32. I think the patient profile who will likely benefit from adaptive DBS is the patient with significant dyskinesias on conventional DBS | 4 ± 1.5 | 4 ± 1 | 4 ± 0—C.R. |
S33. I think that adaptive DBS will improve non-motor aspects of Parkinson’s disease | 3 ± 1 | 3 ± 1 | 3.5 ± 1 |
S34. I think that adaptive DBS will reduce stimulation induced side effects | 4 ± 1 | 4 ± 0.25 | 4 ± 0 |
S35. I think the long-term impact of adaptive DBS might be positive for the patients | 4 ± 0.5 | 4 ± 1 | 4 ± 0—C.R. |
S36. I think adaptive DBS might more easily adapt to pharmacological changes | 4 ± 1 | 4 ± 1 | 4 ± 0 |
S37. I think adaptive DBS leads to faster stable treatment response after DBS surgery once a setting is defined | 4 ± 1 | 4 ± 1 | 4 ± 0—C.R. |
S38. I think fast adaptation adaptive DBS leads to long term plastic changes | 3 ± 1 | 3 ± 0.25 | 3 ± 0—C.R. |
S39. I think adaptive DBS will improve patient’s well-being because adaptive DBS automatically increases stimulation if patient forgets to take medication | 3 ± 1.5 | 4 ± 1 | 4 ± 1 |
S40. I think adaptive DBS will improve patient’s well-being because adaptive DBS automatically decreases stimulation if patient accidentally takes too high a dose of medication | 4 ± 1 | 4 ± 1 | 4 ± 1 |
S41. I think adaptive DBS decrease the number of patient visits to neurologists for programming | 3 ± 1.5 | 3 ± 2 | 3 ± 0.25 |
S42. I think adaptive DBS makes medication titration easier – with less precision required | 3 ± 1 | 3 ± 0.25 | 3 ± 0.25 |
