Utilization of intraoperative Subthalamic Nucleus local field potential recordings to guide postoperative Deep Brain Stimulation programming in Parkinson’s disease (P5-11.013)

Abstract

<h3>Objective:</h3> To investigate whether intraoperative recordings of subthalamic nucleus (STN) local field potentials (LFPs) during awake deep brain stimulation (DBS) surgery for Parkinson’s disease can provide valuable information for postoperative DBS programming. <h3>Background:</h3> DBS is a well-established treatment of Parkinson’s disease. Intraoperative LFP recordings during awake DBS surgery are used to confirm accurate targeting. Postoperative DBS programming is usually based on clinical response. It is unclear whether the intraoperative LFP recordings can guide postoperative DBS programming. <h3>Design/Methods:</h3> All patients with Parkinson’s disease who had awake placement of STN DBS electrodes with intraoperative STN LFP recordings (Alpha Omega LeadConfirm®) at the University of Utah since August 2021 were identified. The peak beta band power for each individual electrode contact was identified. For directional electrodes, the LFP beta peaks were averaged across the three directional contacts for each level. Postoperatively the DBS systems were programmed based on symptom response. The activated DBS levels were compared to the levels with the highest and lowest LFP beta band peaks. <h3>Results:</h3> 13 DBS STN electrodes, from 8 patients (all males, mean age=60±10 years, mean UPDRS score=40±14) were analyzed. The grand average peak beta band frequency was 21Hz with power of 2.3. In 2 out of 13 electrodes the level with the highest beta band peak was activated postoperatively. In 8 electrodes the active levels and the levels with the highest peaks were adjacent. In one electrode the contact with the highest peaks provided best benefit but the contact with the lowest beta peak was activated to avoid dyskinesias. <h3>Conclusions:</h3> In the majority of the electrodes (11 out of 13 electrodes) the levels that were post-operatively activated based on best clinical response coincided or were adjacent to the levels with the highest intraoperative STN LFP beta power peaks. The intraoperative LFP recordings can potentially provide valuable information for programming guidance postoperatively. <b>Disclosure:</b> An immediate family member of Dr. Anwer has received personal compensation for serving as an employee of Southwest Airlines. Dr. Anwer has stock in Boeing. Mr. PAXTON has nothing to disclose. Dr. Rahimpour has nothing to disclose. Dr. Alshaikh has nothing to disclose. D. James Ballard has nothing to disclose. Dr. Steffens has nothing to disclose. Ms. Zorn has nothing to disclose. Dr. Kassavetis has nothing to disclose.