Parkinson’s Disease Local Field Potential (LFP) Prevalence Tracking in GPi-DBS Via BrainsenseTM Survey
Omolara Lawal1, Zahir Sheikh2, Anna Tarren3, Marisa Kovach4, Jim McInerney5, Elana Farace6, Sol De Jesus2
1Neurology, Penn State Health Milton S. Hershey Medical Center, 2Penn State Milton S. Hershey Medical Center, 3School of medicine, Penn State College of Medicine, 4PennState Milton S Hershey Medical Center, 5Neurosurgery, Penn State Health Medical Center, 6Penn State Health Medical Center
Objective:

To characterize the local field potentials (LFPs) in Parkinson’s disease (PD) patients implanted in the globus pallidus internus (GPi) using the PerceptTM Deep Brain Stimulation (DBS) system. 

 

Background:
Innovation in the DBS space has led to a clinically available bidirectional system (PerceptTM) capable of stimulating and recording directly from the lead contacts. Clinical characterization of LFPs in chronically implanted PD patients have been primarily available for subthalamic (STN) DBS, there is less presented for GPi DBS.   
Design/Methods:

A quality assurance review of the BrainsenseTM survey at one institution was used for a longitudinal analysis in PD patients who underwent GPi-DBS.  Four survey time points (i.e. initial programming, 1, 3 and 6 months post-operatively) were included for analyses of LFP signals at the start of the programming session in the OFF-medicine state.  Baseline characteristics and clinical information was obtained from the baseline screening clinic. Indication for DBS placement varied amongst the subjects. All were implanted and managed at our institution.

Results:

Four PD patients, 2 males and 2 females, with a mean age of 73 were included for analysis. Average disease duration was 16 years. All 4 individuals had primary difficulties with dyskinesia, two were tremor dominant and two were akinetic-rigid subtype. The individuals selected were managed by our movement disorders neurologist. A beta peak signal [13-30Hz] signature could be identified on the BrainsenseTM survey in all four time points of variable power amongst the 4 patients. Additionally, alpha peak signals [8-12Hz] although present in all four participants demonstrated a higher power in the tremor dominant patients. No significant gamma peaks [31-200Hz] were captured.

Conclusions:

GPi LFPs in the alpha and beta peak range correlating with symptoms were available and are stable for tracking over a 6-month period in patients implanted with the commercially available bidirectional system. 

10.1212/WNL.0000000000204171