Abstract
BackgroundDirectional deep brain stimulation (DBS) technology aims to address the limitations, such as stimulation-induced side effects, by delivering selective, focal modulation via segmented contacts. However, DBS programming becomes more complex and time-consuming for clinical feasibility. Local field potentials (LFPs) might serve a functional role in guiding clinical programming.ObjectiveIn this pilot study, we investigated the spectral dynamics of directional LFPs in subthalamic nucleus (STN) and their relationship to motor symptoms of Parkinson’s disease (PD).MethodsWe recorded intraoperative STN-LFPs from 8-contact leads (Infinity-6172, Abbott Laboratories, Illinois, United States) in 8 PD patients at rest. Directional LFPs were referenced to their common average and time-frequency analysis was computed using a modified Welch periodogram method. The beta band (13–35 Hz) features were extracted and their correlation to preoperative UPDRS-III scores were assessed.ResultsNormalized beta power (13–20 Hz) and normalized peak power (13–35 Hz) were found to be higher in anterior direction despite lack of statistical significance (p > 0.05). Results of the Spearman correlation analysis demonstrated positive trends with bradykinesia/rigidity in dorsoanterior direction (r = 0.659, p = 0.087) and with axial scores in the dorsomedial direction (r = 0.812, p = 0.072).ConclusionGiven that testing all possible combinations of contact pairs and stimulation parameters is not feasible in a single clinic visit, spatio-spectral LFP dynamics obtained from intraoperative recordings might be used as an initial marker to select optimal contact(s).
Highlights
Directional deep brain stimulation (DBS) lead is a major technological advance in the field
We aim to investigate the possible relationship between directional Local field potentials (LFPs) in the subthalamic nucleus (STN) and individual parkinsonian motor symptoms
LFP data collected intraoperatively showed that the normalized beta band power observed in the STN was higher in anterior direction and had positive trends with bradykinesia/rigidity in dorsoanterior and with axial scores in the dorsomedial directions
Summary
Directional deep brain stimulation (DBS) lead is a major technological advance in the field. Artificial neural networks have been shown to deliver quick, generalized computations concerning the volume of tissue activated from the lead (Chaturvedi et al, 2013). Another model utilizes a finite element model to compute the estimated neural activity in the targeted area (Anderson et al, 2018). These computational models have been shown to simplify programming of complex devices by computing optimal contact configurations, the success of these models depends heavily upon the accuracy of the lead placement. Local field potentials (LFPs) might serve a functional role in guiding clinical programming
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