Data from: Clinical scores before and after multi-nodal DBS

<p><em>Background</em></p> <p>Mixed and complex movement disorders represent significant challenges for surgical treatment. These disease states are likely the result of combined or complex network pathologies affecting multiple pathways^1-4. Until recently, attempts to treat complex movement disorders with deep brain stimulation (DBS) have primarily focused on stimulating a single deep target to address patients' most severe symptoms^5-14. However, a multi-nodal targeting approach for DBS by simultaneously stimulating more than one pair of homologous nuclei could be a more effective treatment strategy. Here, we present the technique and initial case series of utilizing multi-nodal stimulation for mixed and complex movement disorders.</p> <p><em>Methods</em></p> <p>An initial cohort of fifteen mixed and complex movement disorder patients presenting to Stanford University underwent a multi-nodal stimulation approach. In these patients, the multiple (i.e. &gt; 2) simultaneous deep targets were implanted through only 2 burr holes and connected to a single 32-channel pulse generator.</p> <p><em>Results</em></p> <p>There were no intra- or post-operative complications. With the addition of multi-nodal stimulation, complex PD patients demonstrated a significant reduction in Unified Parkinson's Disease Rating Scale (p = 0.0039) and complex tremor patients demonstrated a significant reduction in Clinical Rating Scale for Tremor (p = 0.0312).</p> <p><em>Conclusion</em></p> <p>We present the largest initial case series demonstrating the safety, feasibility, and added efficacy of single system multi-nodal DBS for treating mixed and complex movement disorders. This approach is safe, provides additional benefit, and warrants further investigation for treating mixed and complex movement disorders.</p>