Objective: We aimed to assess the feasibility and performance of clinically implemented sensing-based initial deep brain stimulation (DBS) programming for Parkinson’s disease (PD).

Background: Initial DBS programming employing a monopolar review is time-consuming, subjective, and burdensome. Incorporating neurophysiology has the potential to expedite, objectify, and automatize initial DBS programming.

Method: We conducted a single-center retrospective study of 15 PD patients (25 hemispheres) implanted with a sensing-enabled DBS system in whom initial subthalamic nucleus or globus pallidus internus DBS programming was guided by beta power in real-time local field potential recordings, instead of a monopolar review.

Results: The initial sensing-based programming visit lasted on average 42.2 (SD 18) minutes per hemisphere. During the DBS optimization phase, a conventional monopolar clinical review was not required in any of the patients. The initial stimulation contact level remained the same at the final follow-up visit in all hemispheres except three. The final amplitude was on average 0.8 (SD 0.9) mA higher than initially set after the original sensing-based programming visit. One year after surgery, off-med MDS-UPDRS III total score, tremor subscore, MDS-UPDRS IV, and levodopa-equivalent dose improved by 47.0% (p < 0.001), 77.7% (p = 0.001), 51.1% (p = 0.006), and 44.8% (p = 0.011) respectively compared to preoperatively using this approach.

Conclusion: This study demonstrates that sensing-based initial DBS programming for PD is feasible, rapid, and selected clinically effective contacts in the majority of patients, including those with tremor. Further, technological innovations and practical developments could improve sensing-based programming.

« Back to 2024 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/clinically-implemented-sensing-based-initial-programming-of-deep-brain-stimulation-for-parkinsons-disease-a-retrospective-study/