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Prediction of STN DBS Motor Response in PD

Completed
Conditions
Parkinson Disease
Interventions
Other: Prediction of motor outcome after STN DBS based on preoperative variables
Registration Number
NCT04093908
Lead Sponsor
Maastricht University Medical Center
Brief Summary

Despite careful patient selection for subthalamic nucleus deep brain stimulation (STN DBS), some Parkinson's disease (PD) patients show limited improvement of motor disability. Non-conclusive results and the lack of a practical implantable prediction algorithm from previous prediction studies maintain the need for a simple tool for neurologists that provides a reliable prediction on postoperative motor improvement for individual patients.

In this study, a prior developed prediction model for motor response after STN DBS in PD patients is validated. The model generates individual probabilities for becoming a weak responder one year after surgery. The model will be validated in a validation cohort collected from several international centers.

The predictive model is made public accessible before data collection on: https://github.com/jgvhabets/DBSPREDICT

Detailed Description

Predicting motor outcome after STN DBS in Parkinson Disease can be challenging for the clinician. Current prediction studies report non-conclusive results on the most important predictors and are limited by used computational methods. Traditional statistical analyses which focus on correlations are biased by predictor- and confounder-selection by the investigators. Modern computational methods like machine learning prediction models are less limited by sample size and can consider a wider range of predictors which leads to less selection-bias.

Retrospective patient data is collected from multiple international centers. This retrospective, multicenter cohort is used to validate the model which is developed based on a single-center retrospective cohort.

The goal is to develop a prediction tool that provides the clinician with a probability for weak response during the preoperative phase. This could support the clinician in including or informing the patient during preoperative counseling.

The predictive model is made public accessible before data collection on: https://github.com/jgvhabets/DBSPREDICT.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
322
Inclusion Criteria
  • underwent STN DBS for Parkinson's disease
  • completed one year follow up after surgery
Exclusion Criteria
  • missing data in postoperative UPDRS II, III, IV

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
multi-center validation cohortPrediction of motor outcome after STN DBS based on preoperative variablesWe collect retrospective data from several international centers containing preoperative variables (demographical and clinical) and postoperative outcome (UPDRS II, III, IV) one year postoperatively, and merge these data to one validation cohort.
Primary Outcome Measures
NameTimeMethod
predictive accuracyone-year postoperative

See description primary outcome 1.

true positive prediction rateone-year postoperative

See description primary outcome 1.

area under the curve of the receiver operator curveone-year postoperative

Motor outcome is categorised in a binary outcome variable. The model will predict to which outcome group the patient will belong one-year postoperatively. The primary outcome measure is the performance of the predicted outcome categories with the actual outcome categories.

Performance of prediction models is expressed as area under the curve of the receiver operator curve, predictive accuracy, true positive prediction rate, and false positive prediction rate.

false positive prediction rateone-year postoperative

See description primary outcome 1.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

MaastrichtUMC

🇳🇱

Maastricht, Limburg, Netherlands

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