Objective:

We aimed to study coincidence between the contact selected at programming session by experienced neurologists at 6months follow up after bilateral STN DBS (considered standart of care(SoC)) with the contacts with higher low beta power at the inicial programming session, based on neurophysiological data.

Background: Subthalamic nucleus (STN) deep brain stimulation (DBS) is a really effective treatment for motor symptoms in patients with Parkinson´s disease(PD).The usual way most clinicians perform the electrodes programming session follows a trial and error process that requires high expertise and is time consuming. Therefore it could be exhausting for both patients and neurologists. This process can lead to the selection of suboptimal stimulation parameters, being this problem amplified with directional electrodes.

Method: This study was carried out at Clinica Universidad de Navarra, Pamplona, Spain. 14 patients with PD were treated with electrodes targeted at the STN (6/14 with directional

octopolar electrodes), connected to Percept PC IPGs. All patients had undergone DBS programming according to our centre´s SoC treatment before study recruitment. Local field potentials were registered by an independent neurologist before the first stimulation session was carried out in the off medication state. These data were recorded as short bipolar contact pair with the highest beta power (SBP) for each electrode, as the contact with highest beta power in the surrounding bipolar montage (SBM), and the best directionality (BD); A,B or C, for the 6 pairs of directional electrodes recorded.

Results: The total number of electrodes analised was 26 ( 2 electrodes had missing data).  In 21 out of the 26 electrodes the contact selected at 6 months was included in the SBP, in 16 out of 26 the contact selected at 6month follow up was the same as SBM. 9 out of 11 the BD was the same as directionality selected at 6months.

Conclusion: Beta band recorded at initial programming session could be helpful for programming, but it does not always predict the final contact according to our standard of care. Further studies in larger multicentric samples would be required to properly answer this question.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/reliability-of-brainsense-technology-as-compared-to-soc-in-stn-dbs-programming/