Objective: To report preliminary data on the utility of local field potential(LFP)-based programming in bilateral subthalamic nucleus(STN) deep brain stimulation(DBS) for Parkinson’s disease(PD).

Background: Current DBS technology allows for recording of electrophysiological activity(LFP) related to PD symptoms. Real-life data on its utility in the short and mid-term post-implantation phases are scarce.

Method: PD patients on conventional(i.e. clinical monopolar review-based) STN DBS settings since implantation were reviewed 3 and 6 months post-implantation. LFP capture and live streaming guided stimulation location and parameters. Motor(MDS-UPDRS part III off(OFFmeds)/on levodopa and off/on DBS(ONstim),MDS-UPDRS part IV) and quality of life(39-item PD Questionnaire(PDQ-39),DBS Impairment Scale(DBS-IS)) data were collected. Data are reported as medians (interquartile ranges(IQR)) and proportions(%).Comparisons were performed via Wilcoxon matched-pairs signed rank tests.

Results: 18 patients(target n = 23) have been reviewed at 3 and 6 months(11(61.1%) males, age = 59.4 years(53.3 – 67.1), disease duration = 10.5 years(9 – 12), levodopa equivalent daily dose(LEDD) at 3 months = 650mg(400 – 850)).In the OFFmeds state, there was a significant reduction in MDS-UPDRS part III scores on LFP-based parameters versus conventional settings at 3 months(-10 points, IQR -16 to -5, p = 0.0003) and at 6 months(-8.5 points, IQR -32 to -3, p = 0.0015), but no significant differences in LEDD, MDS-UPDRS part IV, PDQ-39 or DBS-IS scores between 3 and 6 months.At 6 months, 11(61.1%) patients remained on the 3-month LFP-based program. Reasons for change were bothersome peak-dose dyskinesias(n = 5, 71.4%) and suboptimal motor control(n = 2, 28.6%).At 3 months, LFP-based and conventional programming contacts coincided in 7(38.9%) patients in the left STN and 6(33.3%) patients in the right STN. 3-month LFP-based optimal contacts remained identical in 15(83.3%) patients in the left STN and in 13(72.2%) in the right STN at 6 months.

Conclusion: LFP-based programming provided significant clinical benefit in this sample.Quality of life differences should be studied over a longer time span.Patient education and close follow-up after LFP-based programming are warranted to address issues such as dyskinesias.Data collection and analyses, including other variables(e.g. non-motor symptoms, comparison with image-guided optimal parameters) are underway.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/value-of-local-field-potential-based-deep-brain-stimulation-programming-in-parkinsons-disease/