Feasibility and Utility of Electrophysiology-Based DBS Programming in Clinical Practice. (P10-11.013)

Abstract

<h3>Objective:</h3> 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). <h3>Background:</h3> 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. <h3>Design/Methods:</h3> 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. <h3>Results:</h3> 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. <h3>Conclusions:</h3> 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. <b>Disclosure:</b> Dr. Del Papa has nothing to disclose. Dr. Feldman has nothing to disclose. Dr. Marmol has nothing to disclose. Jonathan Jagid has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medtronic Inc. The institution of Jonathan Jagid has received research support from Boston Scientific. The institution of Jonathan Jagid has received research support from Medtronic Inc. The institution of Dr. Haq has received research support from NINDS. The institution of Dr. Haq has received research support from the Parkinson’s Foundation. The institution of Dr. Haq has received research support from NIMH. Dr. Haq has a non-compensated relationship as a consultant with Medtronics that is relevant to AAN interests or activities. Dr. Haq has a non-compensated relationship as a consultant with Boston Scientific that is relevant to AAN interests or activities. Dr. Haq has a non-compensated relationship as a consultant with Abbott that is relevant to AAN interests or activities. Dr. Luca has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Boston Scientific. Dr. Luca has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Signant Health.