Directional local field potentials: A tool to optimize deep brain stimulation.
Tinkhauser G., Pogosyan A., Debove I., Nowacki A., Shah SA., Seidel K., Tan H., Brittain J-S., Petermann K., di Biase L., Oertel M., Pollo C., Brown P., Schuepbach M.
BACKGROUND: Although recently introduced directional DBS leads provide control of the stimulation field, programing is time-consuming. OBJECTIVES: Here, we validate local field potentials recorded from directional contacts as a predictor of the most efficient contacts for stimulation in patients with PD. METHODS: Intraoperative local field potentials were recorded from directional contacts in the STN of 12 patients and beta activity compared with the results of the clinical contact review performed after 4 to 7 months. RESULTS: Normalized beta activity was positively correlated with the contact's clinical efficacy. The two contacts with the highest beta activity included the most efficient stimulation contact in up to 92% and that with the widest therapeutic window in 74% of cases. CONCLUSION: Local field potentials predict the most efficient stimulation contacts and may provide a useful tool to expedite the selection of the optimal contact for directional DBS. © 2017 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.