Feasibility and Utility of Electrophysiology-Based DBS Programming in Clinical Practice.
Dylan Del Papa1, Matthew Feldman1, Sarah Marmol1, Jonathan Jagid1, Ihtsham Haq1, Corneliu Luca1
1University of Miami
Objective:

We aim to describe the utility of local field potential (LFP)-based deep brain stimulation (DBS) programming in clinical practice, in patients with DBS implants for Parkinson’s Disease (PD).

Background:

DBS is an effective tool that requires labor-intensive programming by experienced clinicians. Recent technological advances allow the detection of the LFP in the beta-band (13-30Hz), a marker which has been shown to correlate with severity of bradykinesia and rigidity.

Design/Methods:

Eleven PD patients with bilateral implants containing LFP-sensing capability were assessed in clinic off medication and off stimulation to detect the beta peaks. Patients were programmed using standard of care monopolar review. Subsequently, stimulation was activated using the contact with highest beta signal, and beta power modulation in response to stimulation was analyzed. Clinical response was assessed using objective motor scores and patient-reported improvement.

Results:

The majority of the patients had prominent beta peaks in the 13-30 Hz range while off meds and off stimulation. Activation of stimulation was associated with a decrease in beta band power. The best clinical contact correlated with the highest beta peak band in 19 out of the 22 leads, measured in the 11 patients studied.

Conclusions:

In this case-series of PD patients, DBS programming using LFP-sensing seems to be feasible. We have identified a strong correlation between clinical improvement and reduced ß-band activity. Our initial analysis has not yet captured the effects of the programming over an extended period, nor the long-term effects on ß-band activity. Our future goals are to capture more data over time in an expanded cohort allowing for longitudinal analysis and a blinded, randomized-controlled comparison.

10.1212/WNL.0000000000203255