Abstract
Background
Deep brain stimulation (DBS) programming is time intensive. Recent advances in sensing
technology of local field potentials (LFPs) may enable improvements. Few studies have
compared the use of this technology with standard of care.
Objective/Hypothesis
Sensing technology of subthalamic nucleus (STN) DBS leads in Parkinson’s disease (PD)
is reliable and predicts the optimal contacts and settings as predicted by clinical
assessment.
Materials and Methods
Five subjects with PD (n = 9 hemispheres) with bilateral STN DBS and sensing capable battery replacement were
recruited. An LFP sensing review of all bipolar contact pairs was performed three
times. Contact with the maximal beta peak power (MBP) was then clinically assessed
in a double-blinded fashion, and five conditions were tested: 1) entry settings, 2)
off stimulation, 3) MBP at 30 μs, 4) MBP at 60 μs, and 5) MBP at 90 μs.
Results
Contact and frequency of the MBP power in all hemispheres did not differ across sessions.
The entry settings matched with the contact with the MBP power in 5 of 9 hemispheres.
No clinical difference was evident in the stimulation conditions. The clinician and
subject preferred settings determined by MBP power in 7 of 9 and 5 of 7 hemispheres,
respectively.
Conclusions
This study indicates that STN LFPs in PD recorded directly from contacts of the DBS
lead provide consistent recordings across the frequency range and a reliably detected
beta peak. Furthermore, programming based on the MBP power provides at least clinical
equivalence to standard of care programming with STN DBS.
Keywords
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Comments
Article info
Publication history
Published online: February 14, 2023
Accepted:
January 9,
2023
Received in revised form:
December 19,
2022
Received:
October 26,
2022
Publication stage
In Press Corrected ProofFootnotes
Source(s) of financial support: The authors reported funding from Medtronic Collaboration Grant and Boettcher Scholars Program.
Conflict of Interest: Robert Raike, Abbey B. Holt-Becker, and Michelle Case are Medtronic employees. In this study, they provided technical support and assistance in imaging analysis. They were not involved in the conduct of the patient care and did not influence the interpretation of the results. Drew S. Kern and John A. Thompson received funding from Medtronic, PLC to support this study. Study concept, execution, analysis, and interpretation were developed independently by Drew S. Kern and John A. Thompson. The remaining authors report no conflict of interest.
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© 2023 International Neuromodulation Society. Published by Elsevier Inc. All rights reserved.
