Objective:

Evaluate the effectiveness of stimulation contact selection based on EI compared to standard clinical DBS programming.

Background:

Deep brain stimulation (DBS) is an effective treatment for Parkinson’s disease (PD), Essential Tremor (ET), and dystonia. Optimizing DBS settings often requires lengthy trial-and-error programming sessions. Modern DBS systems allow for intracranial electrophysiological recordings, offering a potentially more objective method. A new technology, the BrainSense Electrode Identifier (EI), was introduced to automatically identify the electrode contact with the strongest relevant electrophysiological signal.

Design/Methods:

We conducted a retrospective review of DBS patients at the University of Florida. Inclusion criteria include: 1) Diagnosis of PD, ET or dystonia from a movement disorders neurologist, 2) Bilateral DBS implantation with a Medtronic Percept pulse generator and Medtronic Sensight B33005 or B33015 leads, 3) Completed at least 6 months of DBS programming. We compared the monopolar contact with the highest beta signal to the clinically optimized contact after 6 months.

Results:

We analyzed local field potential recordings from 37 DBS leads implanted in 21 patients: 12 with PD, 7 with ET, and 2 with dystonia. Leads were distributed across three targets: 6 in the subthalamic nucleus (STN), 21 in the Globus Pallidus Internus (GPi), and 10 in the thalamus. The EI-selected contact matched the clinically optimized contact in 56.5% of PD cases, 27.3% of ET cases, and 0% of dystonia cases. By target, matches occurred in 66.7% of STN leads, 42.9% of GPi leads, and 30% of thalamic leads.

Conclusions:

EI showed the highest accuracy in PD cases, especially in STN leads, where it matched clinical contacts in more than 65% of cases. While performance varied across targets, EI may be useful for rapid screening of electrophysiologic biomarkers. However, further research is needed to optimize its clinical utility across diverse patient populations and brain targets.