Functional Use of Directional Local Field Potentials in Parkinson's Disease

Abstract

INTRODUCTION: One of the biggest limitations of deep brain stimulation (DBS) therapy is the stimulation induced side effects due to restricted size of functional areas in subthalamic nucleus (STN) and the proximity of structures. The segmented DBS lead technology aims to address this problem by delivering more selected, focal modulation via smaller, directional contacts. However, the DBS programming becomes more complex and time-consuming for clinical feasibility. Here in this pilot study, we investigated the spectral power distribution of directional local field potentials (LFPs) in STN and their relationship to motor symptoms of Parkinson disease (PD). METHODS: We recorded 8-channel intraoperative LFPs in 9 PD patients at resting and during stimulation OFF. Power-frequency spectra were computed for all individual contacts and then grouped according to which anatomical directions they are facing. Beta (13-20 Hz/20-35 Hz) and alpha (7-12 Hz) band powers were calculated and their correlation to preoperative UPDRS-3 scores (51.7 ± 21.9 d before the DBS surgery) and the clinical programming were evaluated. RESULTS: The average depth-frequency maps demonstrated different spectral dynamics across anterior, medial, and lateral directions. Patients with severe tremor compared to nontremor subjects showed higher beta power in anterior and lateral directions. Beta band power were positively correlated with the tremor severity and significantly correlated with clinical stimulation amplitude (mA) in anterior direction (P