Objective: This study investigates the changes in local field potential (LFP) during acute and chronic deep brain stimulation (DBS) in patients with Parkinson’s disease (PD) due to the direct DBS effect on neural circuits and neuroplastic changes induced by chronic DBS stimulation.

Background: While DBS has been recognized for its clinical benefits in treatment of PD patients, its mechanism of action has not been elucidated yet, and DBS programming is still a trial and error. DBS long-term stimulation effects imply neuroplastic-induced changes. This effect has been studied in animal models but is still poorly understood in patients with Parkinson’s disease.

Method: We conducted a longitudinal study involving ten PD patients who underwent acute and chronic DBS implantation. Following their initial implant surgery, patients were scheduled for LFP data collection monthly for first 4 months post-implant and then every 3 months after that. Prior to each session, patients were Off PD medication for 12 hours, with DBS devices active. During the one-hour data collection sessions, DBS was temporarily turned off, and LFP data was recorded at 5, 10, 15, 30, 45, and 60-minute intervals. Each recording lasted 45 seconds while patients maintained a rest posture and we recorded three trials for each interval. After data collection, DBS devices were turned back on to their original settings. A multivariate regression analysis was applied to the LFP data.

Results: This study is an observational study, and we anticipate that the data analysis of this larger cohort will test the hypothesis of our previous pilot study, where we observed a shift towards a lower beta and narrower beta power spectrum, which implies less beta bursting activity as observed in animal studies.

Conclusion: Challenges with a large number of subjects will be due to the pleiotropy of the PD phenotypes, genotypes, disease duration and patient age, different comorbidities, and not to omit the changes due to the disease progression and the neuroplastic changes due to DBS stimulation.

Pattern identifications will help with DBS parameter optimization and the development of closed-loop-adaptive DBS therapy.

References: Feldmann LK, Neumann WJ, Krause P, Lofredi R, Schneider GH, Kühn AA. Subthalamic beta band suppression reflects effective neuromodulation in chronic recordings. Eur J Neurol. 2021 Jul;28(7):2372 2377. doi :10.1111/ene.14801. Epub 2021 Mar 26. PMID: 33675144.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/longitudinal-studies-of-lfp-activities-during-acute-and-chronic-dbs-stimulation-in-pd-patients/