Electrophysiology-based Deep Brain Stimulation Programming for Parkinson's Disease
University of Florida
Summary
Deep brain stimulation (DBS) effectively alleviates motor symptoms in Parkinson's disease (PD). However, current programming is manual and time-consuming. This study will evaluate physiology-based programming using local field potentials (LFPs) to identify optimal stimulation parameters. Specifically, DBS contact selection based on beta power and a broad-band approach will be compared with conventional clinician-based programming.
Description
Up to thirty patients with DBS (unilateral or bilateral leads) attached to a bidirectional implantable pulse generator will be enrolled in this study. This commercially available IPG allows both therapeutic stimulation and chronic sensing. It has been designed to capture local field potentials (LFPs) from implanted DBS leads while delivering stimulation both inside and outside the clinic. After recording LFP data, then, the physician will perform the traditional clinical monopolar review and determine the optimized DBS settings ('clinician-based' settings) following standard clinical procedur…
Eligibility
- Age range
- 21–89 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Patients with a diagnosis of idiopathic PD fulfilling the Movement Disorder Society Clinical Diagnostic Criteria for PD * DBS implantation with the Percept DBS device (Medtronic, USA) for the treatment of motor symptoms * Ability to give informed consent for the study * Willingness to do this study at the time of the initial programming session * Age 21 to 89 years old Exclusion Criteria: * Inability to comply with the study protocol * Atypical Parkinsonism * Any personality or mood symptoms that study personnel believe will interfere with the study requirements
Interventions
- DeviceClinician-based DBS programming
Contacts, amplitude, pulse width, and frequency are chosen by the treating physician during a conventional monopolar review.
- DeviceMaximum Beta power-based DBS programming
The contact that shows the strongest beta activity (13-30 Hz) in the local field potentials is selected for stimulation.
- DeviceBroad-band electrophysiology-based DBS programming
A multi-frequency algorithm that integrates beta, theta/alpha, finely tuned gamma, and other relevant bands is used to identify the optimal contact.
Location
- Norman Fixel Institute for Neurological DiseasesGainesville, Florida