Objective: To characterize programming configurations and local field potentials (LFP) control parameters in a multicenter, real-world cohort of patients receiving deep brain stimulation (DBS) for Parkinson’s disease (PD) with the option to use adaptive DBS (aDBS).

Background: aDBS, designed to adapt stimulation according to thresholds of LFP fluctuations, is an emerging personalized therapy for PD and is commercially available in Japan. However, data regarding aDBS programming characteristics and LFP fluctuations in a real-world sample is limited.

Method: Device data from 105 patients (age: 63.3 (9.6); sex: 60-F; disease duration: 13.0 (5.7) years) who were enrolled in a prospective, observational, multi-center aDBS Japan Registry as of July 2023 was analyzed. Stimulation mode selection, aDBS stimulation and LFP thresholds, and LFP frequency used as a control signal for aDBS were summarized at initial aDBS programming and latest follow-up.

Results: A total of 62 patients were programmed to aDBS during the study, with aDBS activation occurring at a median of 80.5 [Interquartile Range (IQR): 88] days after surgery. Patients with replacement devices (N=22) were less likely to be programmed to aDBS (31.8%), compared to 66.2% of therapy naïve patients (N=83). The sensing frequency used to control aDBS was set to a median of 15.6 [5.6] Hz at first activation and 16.6 [5.6] Hz at the latest programming. The median upper and lower LFP thresholds at first activation were 862.6 [862.6] Least Significant Bit (LSB) for upper and 292.5 [317.9] LSB for lower thresholds and 707.8 [1365.6] LSB for upper and 291.5 [524.3] LSB for lower thresholds at latest programming. The median upper and lower stimulation amplitudes at first activation were 2.2 [1.2] mA for upper and 1.6 [0.9] mA for lower and 2.4 [1.1] mA for upper and 2.0 [1.0] mA for lower amplitudes at latest programming. During aDBS, the median LFP fluctuation ranges were median 778.5 [1625.3] LSB for upper and 341 [719.3] LSB for lower LFP power at the latest programming.

Conclusion: Here we report aDBS programming characteristics from an interim analysis from the largest, real-world sample of aDBS for PD. We found higher use of aDBS in therapy naïve patients and an average control signal within the low-beta range.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/real-world-programming-and-sensing-from-adaptive-deep-brain-stimulation-for-parkinsons-disease-in-japan/