Objective: To evaluate changes in levodopa equivalent daily dose (LEDD) following deep brain stimulation (DBS) with local field potential (LFP)-guided programming in patients with Parkinson’s disease.
Background: Deep brain stimulation of the subthalamic nucleus is an established treatment for patients with Parkinson’s disease whose symptoms are inadequately controlled with medication. Previous studies have reported reductions in dopaminergic medication of approximately 30–50% following DBS [1–3]. Newer DBS systems capable of recording local field potentials may assist in optimising stimulation parameters during programming. However, real-world data on medication reduction following LFP-guided programming remain limited.
Method: We conducted a retrospective audit of patients with Parkinson’s disease who underwent subthalamic nucleus DBS implantation and received LFP-guided programming at a UK tertiary centre between April 2022 and April 2025. Levodopa equivalent daily dose (LEDD) was calculated using established conversion factors. Baseline LEDD prior to DBS implantation was compared with LEDD recorded at 6 and 12-month follow-up. We conducted a retrospective audit of patients with Parkinson’s disease who underwent subthalamic nucleus DBS implantation and received LFP-guided programming at a UK tertiary centre between April 2022 and April 2025. Levodopa equivalent daily dose (LEDD) was calculated using established conversion factors. Baseline LEDD prior to DBS implantation was compared with LEDD recorded at 6 and 12-month follow-up.
Results: Thirty nine (31 male, 8 female) patients were included. Mean baseline LEDD was 1245mg/day. At 6 months, mean LEDD decreased to 856 mg/day, representing a 31% reduction in medication burden. At 12 months, mean LEDD was 849 mg/day, corresponding to a 32% reduction from baseline. Ten patients (34%) achieved ≥40% reduction in LEDD at 6 and 12 months respectively.
Conclusion: In this real-world cohort, LFP-guided DBS programming was associated with substantial reductions in dopaminergic medication six months and one year after implantation. The magnitude of reduction observed is consistent with previously reported outcomes following DBS and supports the effectiveness of LFP-guided programming strategies in routine clinical practice.
References: 1.Lanore, A.; Houot, M.; Basset, A.; Bendetowicz, D.; Menon, P.J.; Bardinet, E.; Fernandez Vidal, S.; Cornillault, J.; Karachi, C.; Navarro, S.; et al. Understanding Dopaminergic Dose Reduction Following STN-DBS: Mediation Analysis. BMJ Neurol. Open 2026, 8, e001427, doi:10.1136/bmjno-2025-001427.
2. Guduru, Z.; Schramke, C.; Baser, S.; Leichliter, T. Medication Reduction After DBS Placement in Parkinson’s Disease (P6.383). Neurology 2016, 86, doi:10.1212/WNL.86.16_supplement.P6.383.
3. Theyer, C.; Beliveau, V.; Krismer, F.; Peball, M.; Mair, K.; Heim, B.; Djamshidian, A.; Kiechl, S.; Eisner, W.; Eschlböck, S.; et al. Long‐Term Medication Profiles in Parkinson’s Disease under Subthalamic Deep Brain Stimulation: A Controlled Study. Mov. Disord. Clin. Pract. 2024, 11, 855–860, doi:10.1002/mdc3.14065.
To cite this abstract in AMA style:
M. Pagan, F. Kotsi, M. Boca. Dopaminergic Medication Changes Following LFP-Guided Deep Brain Stimulation Programming in Parkinson’s Disease: A Single-Centre Audit [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/dopaminergic-medication-changes-following-lfp-guided-deep-brain-stimulation-programming-in-parkinsons-disease-a-single-centre-audit/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/dopaminergic-medication-changes-following-lfp-guided-deep-brain-stimulation-programming-in-parkinsons-disease-a-single-centre-audit/