Objective: To correlate local field potentials recording with the location of the electrodes according the images obtained with the software Lead-DBS and clinical outcome one year after surgery.

Background: During the last 15 years deep brain stimulation (DBS) has been established as a highly-effective therapy for advanced Parkinson’s disease (PD). To treat medically refractory levodopa-induced motor complications or resistant tremor the preferred target for high-frequency DBS is the subthalamic nucleus (STN). A precise placement of the electrode within this nucleus is crucial for good clinical outcomes. Since March 2021 the recording of local field potentials (LFP) is possible thanks to the new device Percept TM-Medronic with brainsense technology.

Method: Data on 56 patients implanted with the new device Percept-Medtronic will be presented. All of them underwent surgery at the Movement Disorders Unit in the University Hospital Cruces  from June 2021-February 2024. Brainsense to detect beta band was performed one month after the surgery. Patients were classified in 3 different groups according to lead location using the LEAD-DBS software: 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: 56 patients (22 women and 34 men) were included and 112 leads analyzed. Mean age was 61.2years (±8.1) and mean disease duration was 10.08years (±3.5). 80 leads were optimal, 22 suboptimal and 10 were located out of the SNT. Patients with both leads optimal and those with 1 side optimal and the contralateral suboptimal (8 patients) showed improvement in motor scale after surgery. Those with both leads suboptimal (2 patients) and those located out of the STN (10 patients) did not showed any clinical improvement and needed a second time surgery looking for a better location. In all patients beta band was detected independently of the location of electrode.

Conclusion: The recording of the LFT beta band activity does not correlate in our series with the location of the electrode within the STN. Recording of beta band helps selecting the contact when electrode is well located. However, it does not help to localize the lead out of the STN.

References: – Rosa M., Marceglia S., Barbieri S., Priori A. Local Field Potential and Deep Brain Stimulation (DBS). In: Jaeger D., Jung R. (eds) Encyclopedia of Computational Neuroscience. Springer, New York, NY; 2014.
– Andreas Horn, Ningfei Li, Till A. Dembek, Ari Kappel, Chadwick Boulay, Siobhan Ewert, Anna Tietze, Andreas Husch, Thushara Perera, Wolf-Julian Neumann, Marco Reisert, Hang Si, Robert Oostenveld, Christopher Rorden, Fang-Cheng Yeh, Qianqian Fang, Todd M. Herrington, Johannes Vorwerk, Andrea A. Kühn. Lead-DBS v2: Towards a comprehensive pipeline for deep brain stimulation imaging, NeuroImage, Volume 184, 2019, Pages 293-316.
– High frequency oscillations in the subthalamic nucleus: a neurophysiological marker of the motor state in parkinson´s disease. Exp Neurol. 2011 Jun; 229(2):324-31

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MDS Abstracts - https://www.mdsabstracts.org/abstract/is-the-new-device-percept-medtronic-really-helping-clinicians-identifying-location-of-contacts-within-the-stn-in-stn-dbs/