Objective: We aimed to investigate LFP changes during acute and chronic DBS in Parkinson’s Disease (PD) patients. Our study implies neuroplastic changes during stimulation, and that the reversibility of the effect would be affected by the neuroplasticity.

Background:
In PD, a multi-system disease, DBS neuromodulation improves aspects of motor behavior like bradykinesia, rigidity, dyskinesia, and tremor with sustained benefit for years but does not maintain the same chronic benefit on axial symptoms – gait and balance.
The neuroplastic effect studied in animal models can only be inferred in clinical observation

Method: Two PD patients underwent clinical evaluation using the UPDRS-3. We recorded LFPs from patients implanted with PERCEPT™ PC NEUROSTIMULATOR from the site of DBS stimulation. DBS programming was adjusted to the best therapeutic window.
Patients with PD had unilateral DBS surgery targeting either the STN or GPi contralateral to the most affected side of the body using Micro Electrode Recording (MER) for refining the targeting.
The patients returned to the clinic for DBS programming and LFPs were recorded 1 month post-implant, before the DBS stimulator was turned ON and the monopolar review occurred. The DBS parameters selected were based on the therapeutic window of each contact.
Patients returned to the clinic for LFP data collection (2,3,6, and 12 months post-implant). Patients arrived in OFF MEDS for 12 hours and were tested with prior month’s DBS parameters (OFF MEDS/OFF DBS condition). The LFPs were recorded before any DBS parameters were adjusted. LFPs were recorded in intervals of 5, 10, 15, 30, 45 and 60min while the participant is at rest. If needed, the DBS parameters were further adjusted. In parallel with DBS adjustment, the clinician lowered the medication regimen.

Results: Across both the patients, we observe a shift towards lower beta and narrower beta power spectrum, which implies less beta bursting activity as observed in animal studies.

Conclusion: This study was an observational study, we anticipate challenges with large number of subjects due to pleiotropy of the PD phenotypes, genotypes, different comorbidities, etc. A computational model development will help with choosing optimal stimulation parameters, and potentially help in building the adaptive close loop DBS therapy.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/investigative-study-of-local-field-potential-lfp-changes-during-acute-and-chronic-deep-brain-stimulation-dbs-in-parkinsons-disease-pd-patients/