Objective: To retrospectively compare several local field potential (LFP)-guided approaches for contact selection with an imaging-guided strategy and monopolar reviews, using long-term motor outcome as a reference.

Background: LFP-guided deep brain stimulation based on beta-band activity from implanted electrodes is increasingly available for Parkinson’s disease. Beta power is often used to identify contacts presumed to lie within therapeutically effective regions of the subthalamic nucleus. Whether these strategies offer advantages over conventional approaches, particularly anatomically informed imaging-based selection and monopolar review, remains insufficiently evaluated against long-term clinical outcomes.

Method: Contact selections from three strategies were compared in a retrospective cohort of 21 patients (42 hemispheres): LFP-guided approaches, monopolar review, and anatomically informed selection using commercially available imaging software. LFP-guided strategies were based on three previously published methods estimating pseudo-monopolar beta power for individual contacts (1–3). A recently introduced automated LFP-based contact selection tool was not included because it was not yet clinically available in this cohort when the protocol was developed. The anatomically informed approach followed an algorithm prioritizing the motor subdivision of the subthalamic nucleus. Similarity between predicted contacts and chronic stimulation settings at 12-month follow-up was quantified using Dice coefficients. Associations between predicted contact locations and hemispheric motor improvement (UPDRS III) were analyzed.

Results: At group level, LFP-guided strategies and monopolar review showed no statistically meaningful association with contralateral motor improvement. In contrast, anatomically informed contact selection showed a clear and statistically significant correlation with improvement in contralateral UPDRS III hemi-scores.

Conclusion: In this cohort, anatomically guided contact selection targeting the motor region of the subthalamic nucleus predicted long-term motor improvement, whereas LFP-guided strategies and monopolar review did not. These findings support prospective studies directly comparing these approaches in DBS programming.

Power spectral Density graphs of LFP-measurements

References: (1) Behnke, J. K.; Peach, R. L.; Habets, J. G. V.; Busch, J. L.; Kaplan, J.; Roediger, J.; Mathiopoulou, V.; Feldmann, L. K.; Gerster, M.; Vivien, J.; Schneider, G.-H.; Faust, K.; Krause, P.; Kühn, A. A. Long-Term Stability of Spatial Distribution and Peak Dynamics of Subthalamic Beta Power in Parkinson’s Disease Patients. Mov. Disord. 2025, 40 (6), 1070–1084. https://doi.org/10.1002/mds.30169.
(2) Busch, J. L.; Kaplan, J.; Bahners, B. H.; Roediger, J.; Faust, K.; Schneider, G.-H.; Florin, E.; Schnitzler, A.; Krause, P.; Kühn, A. A. Local Field Potentials Predict Motor Performance in Deep Brain Stimulation for Parkinson’s Disease. Mov. Disord. 2023, 38 (12), 2185–2196.
(3) Strelow, J. N.; Dembek, T. A.; Baldermann, J. C.; Andrade, P.; Jergas, H.; Visser-Vandewalle, V.; Barbe, M. T. Local Field Potential-Guided Contact Selection Using Chronically Implanted Sensing Devices for Deep Brain Stimulation in Parkinson’s Disease. Brain Sci. 2022, 12 (12), 1726. https://doi.org/10.3390/brainsci12121726.

« Back to 2026 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/a-retrospective-comparison-of-multiple-approaches-to-lfp-guided-and-imaging-guided-contact-selection-in-subthalamic-deep-brain-stimulation-for-parkinsons-disease/