Objective: To evaluate changes of local field potential (LFP) in patients with Parkinson’s disease (PD) by patient conditions and overtime for one year after surgery measured through the electrode of deep brain stimulation (DBS).

Background: In PD, motor complication, including wearing off and levodopa-induced dyskinesia, becomes problematic in an advanced stage. To handle these problems, adaptive DBS that can automatically change the stimulation amplitude dependent on the LFP as a biomarker of PD symptoms has been available in Japan. However, there are few reports on chronic clinical use. Therefore, we report the changes in LFP based on the patient’s conditions and time after surgery.

Method: We enrolled the patients who implanted the implantable pulse generator, which can use adaptive mode in the bilateral subthalamic nucleus from 2020 to 2021, in Juntendo university hospital. We collected LFP data, including contact information, frequency, and peak power at 1, 3, 6, and 12 months after DBS surgery. Moreover, at the 1-year evaluation, we collected LFP data in five conditions; OFF-medication/ON-stimulation, OFF-medication/OFF-stimulation, OFF-medication/OFF-stimulation with saline, ON-medication/OFF-stimulation, ON-medication/ON-stimulation.

Results: The LFP data were corrected for 20 electrodes from 10 patients. The concordance rate between the contacts with the most substantial beta peak and aDBS sensing set-up was 61.1%, 42.1%, 35.3%, and 72.2% at 1, 3, 6, and 12 months after surgery. The concordance rate between the LFP peak frequency and aDBS sensing set-up was 38.9%, 52.6%, 44.4%, and 50.0% at 1, 3, 6, and 12 months after surgery. In the 5-conditions test, the stimulation and medication suppressed the beta peak represented motor symptoms. Moreover, saline could also suppress beta peak by improving motor symptoms. Eight out of 20 electrodes (40%) showed changes in LFP reflecting symptoms, 4 showed artifacts from an electrocardiogram, and eight showed LFP unrelated to symptoms.

Conclusion: We could capture the LFP changes reflected in the medical treatment, stimulation, and even by the placebo. We revealed that the adequate setting of LFP sensing changes over time after surgery, and our result showed appropriate sensing can be performed by frequently reviewing the settings. The aDBS needs to be set up in the proper timing and method.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/local-field-potential-changes-by-the-patients-conditions-1-year-follow-up-of-adaptive-deep-brain-stimulation-in-the-real-world/