Category: Surgical Therapy: Parkinson's Disease
Objective: To identify the best tool for guidance in an initial programming of deep brain stimulation (DBS).
To explore the potential correlation between postoperative images created with Lead-DBS software, the recording of the LFT beta band activity and the clinical improvement one year after surgery.
Background: DBS is a highly efficacious treatment option in Parkinson´s disease (PD). A precise placement of the electrode is crucial for optimal clinical outcomes and knowing where the electrode is located is the main challenge for neurologist. Since March 2021 the recording of local field potentials (LFP) is possible thanks to the new device Percept TM-Medronic with brainsense technology. There is an association between beta band and bradykinesia and rigidity.
Method: 13 PD patients with an implanted neurostimulator capable of sensing were recruited from the Movement Disorders Unit at the University Hospital Cruces. LFP-beta band were analyzed one month after the surgery. 3D planification of the virtual electrode location was performed using the Lead-DBS 2.5.2 software. Patients were classified in 3 different groups according to this planification: optimal, suboptimal and outside of the STN. Clinical assessment of all patients using UPDRS I, II, III and IV was done one year after the surgery.
Results: 13 patients in an OFF levodopa state, with DBS off were investigated. Mean age was 51.07 years (±7.8) and mean disease duration was 11.61 years (±3.4). The electrode location was classified as optimal in 10 patients, suboptimal in 2 patients and out of the STN in 1 patient. In all patients beta band was detected independently of their location in the STN (mean frequency of 21.73 Hz). In the optimal group an improvement of 1.3 was observed in the UPDRS part I, 7.4 in part II, 16.6 in part III and 3.5 in part IV. In the suboptimal group an improvement of 1 points in UPDRS part I, 4.5 in part II, 12.5 in UPDRS III and 3 points in UPDRS IV was observed. The patients with the electrode out of STN did not show any improvement after one year of surgery.
Conclusion: There is a good correlation on postoperative images and the recording of the LFT beta band activity in those cases where the electrode is well located. However, it does not help to localize the lead out of the STN. Recording of beta band helps selecting the contact when electrode is well located. A combination of both tools is the best approach in clinic.
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To cite this abstract in AMA style:
M. Ruiz-Lopez, B. Tijero, T. Fernandez, G. Bilbao, JC. Gomez-Esteban, E. Ruiz Degopegui. Does beta band activity correlate with electrode location within the STN in postoperative processed images? [abstract]. Mov Disord. 2023; 38 (suppl 1). https://www.mdsabstracts.org/abstract/does-beta-band-activity-correlate-with-electrode-location-within-the-stn-in-postoperative-processed-images/. Accessed November 21, 2024.« Back to 2023 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/does-beta-band-activity-correlate-with-electrode-location-within-the-stn-in-postoperative-processed-images/