Employing LFP recording to optimize stimulation location and amplitude in chronic DBS for Parkinson’s disease: A proof-of-concept pilot study

ObjectivesParkinson patients with chronic DBS routinely receive sensing-enabled implantable pulse generators upon battery replacement. Here we aimed to assess whether and/or how local field potential based reprogramming may be of use in this population.MethodsIn four Parkinson patients on chronic treatment with bilateral STN-DBS and implanted with the Percept™ PC implantable pulse generator, we employed an approach to select stimulation contacts and amplitudes based on beta-activity. When applicable, the effect of parameter adjustments on DBS effectiveness and DBS-induced side effects was assessed.ResultsIn one out of eight electrodes, the LFP-guided contact was different from the clinically determined one. Beta-based therapeutic windows could be defined in five out of eight electrodes. LFP-guided parameter adjustments were performed in two patients, resulting in improved motor fluctuations and decreased stimulation-induced side effects respectively.DiscussionLFP-guided DBS reprogramming has the potential to improve effectiveness and decrease side effects in selected cases. Prospective controlled research is required to assess the clinical usefulness of LFP-guided DBS reprogramming.