Employing LFP recording to optimize stimulation location and amplitude in chronic DBS for Parkinson’s disease: A proof-of-concept pilot study
Bart Swinnen, Mariëlle J. Stam, Arthur W.G. Buijink, Martijn G.J. de Neeling, P.R. Schuurman, Rob M.A. de Bie, Martijn Beudel
Abstract
ObjectivesParkinson patients with chronic DBS routinely receive sensing-enabled implantable pulse generators upon battery replacement. Here we aimed to assess whether and/or how local field potential based reprogramming may be of use in this population.MethodsIn four Parkinson patients on chronic treatment with bilateral STN-DBS and implanted with the Percept™ PC implantable pulse generator, we employed an approach to select stimulation contacts and amplitudes based on beta-activity. When applicable, the effect of parameter adjustments on DBS effectiveness and DBS-induced side effects was assessed.ResultsIn one out of eight electrodes, the LFP-guided contact was different from the clinically determined one. Beta-based therapeutic windows could be defined in five out of eight electrodes. LFP-guided parameter adjustments were performed in two patients, resulting in improved motor fluctuations and decreased stimulation-induced side effects respectively.DiscussionLFP-guided DBS reprogramming has the potential to improve effectiveness and decrease side effects in selected cases. Prospective controlled research is required to assess the clinical usefulness of LFP-guided DBS reprogramming.