Objective: To examine the use of new Deep Brain Stimulation (DBS) local field potential (LFP) sensing technology for selecting the optimal electrode configuration for stimulation during initial DBS programming and compare the results to traditional monopolar review (MR) in patients with Parkinson’s Disease (PD).
Background: DBS with LFP-sensing technology can measure neuronal electrical activity as it provides therapeutic stimulation. Abnormal LFP activity in the beta range within the subthalamic nucleus (STN) and globus pallidus internus (GPi) is correlated with symptoms of akinesia and rigidity. Electrode pairs that sense strong LFP activity may be near the region of abnormal synchronization and thus provide maximal therapeutic benefit when used to stimulate. This has the potential to guide selection of optimal electrodes for stimulation, reducing the need for lengthy clinical testing such as monopolar review.
Method: We performed a retrospective chart review collecting demographics, programming data and 12-week outcomes for the first 8 consecutive PD patients to be implanted in either bilateral STN or GPi with a DBS system with LFP-sensing technology at UT Health San Antonio. We compared the best electrode determined by MR and LFP-sensing using a novel protocol for interpreting LFP data during the initial post-operative programming. We then calculated the percent agreement and correlation between electrodes selected by LFP and MR.
Results: Abnormal LFP activity in the beta range was present in all 16 hemispheres analyzed. Our LFP protocol determined an optimal electrode in all cases. LFP data and MR agreed on the optimal electrode in only 5/16 hemispheres (31%) but agreed within 1 electrode of each other in 15/16 hemispheres (93%). There was moderate correlation between electrodes selected by LFP and MR (r=0.53, p=0.03) [figure 1]. At week 12, electrode configurations were changed in 4/16 hemispheres, 2 for use of directional stimulation, and 2 in the direction of the electrode favored by LFP data.
Conclusion: Both MR and LFP-sensing have limitations for determining best electrodes. Our findings suggest LFP-sensing tools can provide a valuable complement or alternative to monopolar review for the selection of best stimulating electrodes. More study is needed to define the best protocol for interpreting LFP-sensing data and determine if LFP-sensing can fully replace monopolar review.
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To cite this abstract in AMA style:
B. Seegmiller, P. Coss. Local field potentials can guide programming of Deep Brain Stimulation in Parkinson’s Disease [abstract]. Mov Disord. 2023; 38 (suppl 1). https://www.mdsabstracts.org/abstract/local-field-potentials-can-guide-programming-of-deep-brain-stimulation-in-parkinsons-disease/. Accessed June 15, 2025.« Back to 2023 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/local-field-potentials-can-guide-programming-of-deep-brain-stimulation-in-parkinsons-disease/