Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Sep 19, 2025
Open Peer Review Period: Sep 19, 2025 - Nov 14, 2025
Date Accepted: Apr 16, 2026
(closed for review but you can still tweet)
Influence of online sessions via a deep brain stimulation device: a prospective, single-arm, longitudinal, nonrandomized self-controlled cohort study
ABSTRACT
Background:
Deep brain stimulation (DBS) surgery has been widely performed in patients with advanced Parkinson’s disease (PD). Recent advances in technology have provided remote programming functions on DBS devices. These online sessions for de novo DBS implanted PD patients have been reported safe and effective, the same as in-clinic sessions. However, the evidence of online sessions for chronically DBS implanted PD patients is still insufficient.
Objective:
To investigate the safety and efficacy of telemedicine in chronically DBS implanted PD patients.
Methods:
A prospective, single-arm, longitudinal, nonrandomized self-controlled cohort study has been conducted. Eighteen patients with chronically DBS implanted PD patients were included in the study. Two in-clinic sessions are substituted with online sessions. Movement Disorder Society Unified Parkinson’s Disease Rating Scale Part Ⅲ (MDS-UPDRS-Ⅲ) scores were assessed three times at baseline, after in-clinic and online sessions. Multidimensional Evaluation Scale for Patient Impression Change-Japanese version (MPIC-J), Patient’s global impression of Change (PGIC), and Clinical Global Impression of Change (CGI-C) were tested twice after in-clinic and online sessions. Telehealth Usability Questionnaire (TUQ) and Online Usability Questionnaire for Programming (OUQP) were evaluated once after online sessions.
Results:
MDS-UPDRS-Ⅲ did not show significant differences across three assessments. MPIC-J scores revealed that no items but item3, “overall sleep”, significantly worsened after online sessions. PGIC and CGI-C scores showed no difference between in-clinic and online sessions. TUQ revealed that online sessions are almost favorable for patients, especially in “Usefulness” and “Ease of use and learnability” domains. In contrast, the “Reliability” domain showed relatively unfavorable results. The mean total time and cost saved per visit were 280.00 min and 7,974 Japanese Yen, respectively. One patient experienced a fall and lumbar compression fracture during the on-line visits period and dropped out from the study due to hospitalization.
Conclusions:
Telemedicine demonstrates safety and efficacy in patients with PD carrying chronically implanted DBS devices. For patients with PD, sufficient caregiver support, digital literacy, and reliability of the online system may be important for better feasibility. Regardless of these challenges, online sessions may reduce the burden on patients and caregivers and represent a feasible alternative for the management of patients with advanced-stage PD undergoing chronic DBS therapy. Clinical Trial: Japan Registry of Clinical Trials #jRCT1062230055; https://jrct.mhlw.go.jp/latest-detail/jRCT1062230055
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