Objective: The aim of this study was to clarify the 12-month long-term outcome of Parkinson’s disease (PD) patients receiving adaptive DBS therapy.

Background: During the off phase of motor symptoms of PD, local field potentials (LFPs) of the β band are observed in the basal ganglia, and the intensity of the β band is reported to correlate with the severity of the off symptoms. Adaptive deep brain stimulation (DBS) utilizes a sensing technique that measures LFP from electrodes implanted in the target nucleus and automatically controls the stimulation program. In this study, we examined the long-term outcome of STN-DBS in the adaptive setting.

Method: We include 16 patients who received STN-DBS with Medtronic Percept PC, adaptive DBS compatible neurostimulator and Medtronic DBS leads. Their devices were programmed with adaptive settings from the start of treatment. From the beginning of treatment, adaptive settings were applied. Motor scores of the UPDRS-III and stimulation programs were evaluated at 1, 3, 6, and 12 months after adaptive settings.

Results: 15 patients were selected for STN-DBS and one patient for GPi-DBS. In 26 out of 32 electrodes, beta-band LFPs were detected during the off-state of motor symptoms, and disappeared in the on-state. Beta-band LFP was obtained from at least one hemisphere in all patients, and if Beta-band LFP was obtained from one hemisphere only, adaptive DBS was set based on LFP from one hemisphere bilaterally. Current values were increased by 36.0% (0.75+/-0.33 to 1.02+/-0.42 mA) at one month , 113.3% (1.60+/-0.63 mA) at three month, 164.0% (1.98+/-1.22 mA) at six month, and 182.7% (2.12 +/-1.13 mA)) at 12 month postoperatively compared with those measured just after the implantation, with no deterioration in motor scores. During the course of the study, adaptive settings were invalidated in 6 patients, 3 with artifact-related measurement failure and three with multiple peaks in the beta band. In all cases, the adaptive setting could be adjusted by reconfiguration.

Conclusion: In postoperative acute phase, current value was automatically adjusted according to the increased power demand due to loss of micro lesioning effect of the implantation to maintain the motor function. Adaptive DBS is expected to improve and maintain the motor function of PD patients.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/12-month-long-term-outcomes-of-adaptive-dbs-using-lfp-sensing-technology/