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Local Field Potential-Based Programming: A Proof-of-Concept Pilot Study
Alfonso Fasano1, Carolina Gorodetsky2, Darcia Paul3
1Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, ON, Canada; Division of Neurology, University of Toronto, Toronto, ON, Canada; Krembil Brain Institute, University Health Network, Toronto, ON, Canada; Center for Advancing Neurotechnological Innovation to Application (CRANIA), Toronto, ON, Canada; KITE, University Health Network, Toronto, ON, Canada.
Local field potential (LFP)-based programming streamlines deep brain stimulation (DBS) for conditions with delayed benefits. This pilot study shows LFP monitoring effectively guides DBS adjustments in dystonia and epilepsy patients.
Area of Science:
- Neuroscience
- Biomedical Engineering
Background:
- Deep brain stimulation (DBS) programming is often trial-and-error, especially for conditions with delayed clinical response.
- Current programming strategies are limited and primarily focus on Parkinson's disease.
Purpose of the Study:
- To demonstrate the efficacy of local field potential (LFP)-based programming for DBS.
- To streamline DBS programming for indications with delayed temporal onset of benefit.
Main Methods:
- Utilized a commercial implantable pulse generator (IPG) capable of chronic LFP streaming and recording.
- Programmed DBS in a pediatric patient with generalized dystonia and an adult with refractory epilepsy.
Main Results:
- Identified specific LFP frequency peaks (e.g., 1.95 Hz delta range) correlated with symptom severity in dystonia.
- Observed reduced LFP power at specific frequencies (2.93 Hz, 8.79 Hz) associated with seizure control in epilepsy.
Conclusions:
- LFP-based programming offers a promising approach to optimize DBS settings.
- This method can potentially reduce programming time and improve outcomes for complex DBS indications.
