Dataset Information

Selection of optimal programming contacts based on local field potential recordings from subthalamic nucleus in patients with Parkinson's disease.

ABSTRACT: In the United States, the most commonly used surgical treatment for patients with Parkinson's disease is the implantation of deep brain stimulation (DBS) electrodes within the subthalamic nucleus. However, DBS device programming remains difficult and is a possible source of decreased efficacy.We investigated the relationship between local field potential (LFP) activities in the subthalamic nucleus and the therapeutic response to programming.We recorded LFPs with macroelectrodes placed unilaterally for DBS in 4 PD patients, 3 weeks after implantation, before the start of log-term DBS. Power-frequency spectra were calculated for each of 7 possible electrode contacts or contact pairs, over multiple 5- to 10-minute quiet waking epochs and over 30-second epochs during hand movements. Subsequently, DBS devices were programmed, with testing to determine which electrode contacts or contact pairs demonstrated optimal therapeutic efficacy.For each patient, the contact pair found to provide optimal efficacy was associated with the highest energy in the beta (13-32 Hz) and gamma (48-220 Hz) bands during postoperative LFP recordings at rest and during hand movements. Activities in other frequency bands did not show significant correlations between LFP power and optimal electrode contacts.Postoperative subband analysis of LFP recordings in beta and gamma frequency ranges may be used to select optimal electrode contacts. These results indicate that LFP recordings from implanted DBS electrodes can provide important clues to guide the optimization of DBS therapy in individual patients.

SUBMITTER: Ince NF

PROVIDER: S-EPMC4319368 | biostudies-literature | 2010 Aug

REPOSITORIES: biostudies-literature

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Selection of optimal programming contacts based on local field potential recordings from subthalamic nucleus in patients with Parkinson's disease.

Ince Nuri Firat NF Gupte Akshay A Wichmann Thomas T Ashe James J Henry Thomas T Bebler Margaret M Eberly Lynn L Abosch Aviva A

Neurosurgery 20100801 2

<h4>Background</h4>In the United States, the most commonly used surgical treatment for patients with Parkinson's disease is the implantation of deep brain stimulation (DBS) electrodes within the subthalamic nucleus. However, DBS device programming remains difficult and is a possible source of decreased efficacy.<h4>Objective</h4>We investigated the relationship between local field potential (LFP) activities in the subthalamic nucleus and the therapeutic response to programming.<h4>Methods</h4>We ...[more]

PMID: 20644424

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Project description:Segmented deep brain stimulation leads feature directional electrodes that allow for a finer spatial control of electrical stimulation compared to traditional ring-shaped electrodes. These segmented leads have demonstrated enlarged therapeutic windows and have thus the potential to improve the treatment of Parkinson's disease patients. Moreover, they provide a unique opportunity to record directional local field potentials. Here, we investigated whether directional local field potentials can help identify the best stimulation direction to assist device programming. Four Parkinson's disease patients underwent routine implantation of the subthalamic nucleus. Firstly, local field potentials were recorded in three directions for two conditions: In one condition, the patient was at rest; in the other condition, the patient's arm was moved. Secondly, current thresholds for therapeutic and side effects were identified intraoperatively for directional stimulation. Therapeutic windows were calculated from these two thresholds. Thirdly, the spectral power of the total beta band (13-35 Hz) and its sub-bands low, high, and peak beta were analyzed post hoc. Fourthly, the spectral power was used by different algorithms to predict the ranking of directions. The spectral power profiles were patient-specific, and spectral peaks were found both in the low beta band (13-20 Hz) and in the high beta band (20.5-35 Hz). The direction with the highest spectral power in the total beta band was most indicative of the 1st best direction when defined by therapeutic window. Based on the total beta band, the resting condition and the moving condition were similarly predictive about the direction ranking and classified 83.3% of directions correctly. However, different algorithms were needed to predict the ranking defined by therapeutic window or therapeutic current threshold. Directional local field potentials may help predict the best stimulation direction. Further studies with larger sample sizes are needed to better distinguish the informative value of different conditions and the beta sub-bands.

Dataset Information

Selection of optimal programming contacts based on local field potential recordings from subthalamic nucleus in patients with Parkinson's disease.

Publications

Selection of optimal programming contacts based on local field potential recordings from subthalamic nucleus in patients with Parkinson's disease.

Similar Datasets

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