VALUE OF SUBTHALAMIC NUCLEUS LOCAL FIELD POTENTIALS RECORDINGS IN PREDICITING STIMULATION PARAMETERS FOR DEEP BRAIN STIMULATION IN PARKINSON´S DISEASE

Overview & Synopsis

Objectives: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) can be a highly effective treatment for Parkinsonâ™s disease. However, therapeutic efficacy can be limited by inconsistent targeting of this nucleus. We previously showed that an increase in local field potential (LFP) power over the beta frequency band may provide intra-operative confirmation of STN targeting. Here we test whether the depth of this focal increase also helps predict the depth and voltage chosen for chronic stimulation. Methods: We recorded LFPs from the contacts of 57 DBS electrodes as the latter were advanced in 2 mm steps from above to below the intended surgical target point in STN. Results: A spectral peak in the bipolar LFP was recorded in the 11-35 Hz band at the lowest contact pair that underwent a steep but focal change during electrode descent in all but 3 sides. The depth of the initial intra-operative step increase in beta correlated with the depth of the contact independently chosen for chronic DBS (Spearmanâ™s rho = 0.35, p = 0.01). In addition, the absolute difference between the depths of the initial increase in beta and the contact chosen for chronic DBS correlated with the voltage used for chronic stimulation (rho = 0.322, p = 0.017). Thus more voltage had to be employed if a depth was selected for chronic stimulation that differed from that of the beta generator. Conclusions: On-line spectral analysis of LFPs recorded from the DBS electrode may help identify the optimal therapeutic target in the STN region for DBS.