Session Information
Date: Wednesday, September 25, 2019
Session Title: Physiology and Pathophysiology
Session Time: 1:15pm-2:45pm
Location: Les Muses, Level 3
Objective: To characterize the spatial distribution and spectral profile of local field potential (LFP) activity in the internal segment of the globus pallidus (GPi) in patients with Parkinson’s disease (PD) using directional deep brain stimulation (DBS) leads.
Background: Recordings from directional DBS leads may provide a greater understanding of the role of LFP activity in the pathophysiology of PD and in the selection of contact(s) that optimize clinical benefit. This understanding can inform the development of new stimulation approaches and development of programming algorithms that will further improve clinical outcomes for PD patients undergoing pallidal DBS.
Method: Pallidal LFPs were recorded from externalized leads of 3 patients. Pre-operative high resolution 7-T MR images were registered to post-operative CT scans to determine lead location and electrode segment orientation in the GPi. The spatial distribution of oscillatory activity across lead segments was examined in the context of lead locations and clinical DBS settings.
Results: The spatial topography and spectral profile of oscillatory activity in the 5-35Hz range was highly subject-specific. Consistent across patients, however, was the finding that lead segments facing the posterior-lateral “sensorimotor” regions of GPi had the highest oscillatory power, whereas medial (internal capsule) facing segments had the weakest oscillatory power. Similar to what has been observed in recent studies using directional leads in the STN, DBS lead contacts chosen for optimizing clinical benefit, which were blinded to LFP analyses, incorporated lead segments with the strongest LFP activity in the 5-35Hz frequency range.
Conclusion: These findings are supportive of the hypothesis that LFP activity in the 5-35Hz range is greatest in the sensorimotor territory of the GPi and appeared to correlate with the site of stimulation that gave the greatest clinical benefit. These results support further exploration of the relationships between the spatial distribution of LFP activity, patient phenotype, and therapeutic contact selection, and highlight the need for DBS approaches based on subject-specific LFP biomarkers.
To cite this abstract in AMA style:
L. Johnson, J. Aman, D. Escobar Sanabria, J. Wang, R. Patriat, M. Petrucci, M. Hill, G. Molnar, S. Cooper, L. Schrock, C. Mackinnon, N. Harel, M. Park, J. Vitek. Local field potential recordings in the human pallidum using externalized directional DBS leads [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/local-field-potential-recordings-in-the-human-pallidum-using-externalized-directional-dbs-leads/. Accessed November 21, 2024.« Back to 2019 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/local-field-potential-recordings-in-the-human-pallidum-using-externalized-directional-dbs-leads/