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Updated: Aug 2, 2026
Controlling Parkinson's Disease With Adaptive Deep Brain Stimulation
Published on: July 16, 2014
Unipolar recordings of beta power inform initial programming of the subthalamic nucleus in Parkinson's disease
John A Thompson1, Erin M Radcliffe2, Steven Ojemann3
1University of Colorado Anschutz Medical Campus, Department of Neurosurgery, USA; University of Colorado Anschutz Medical Campus, Department of Neurology, USA; University of Colorado Anschutz Medical Campus, Department of Psychiatry, USA.
Background:
Optimizing deep brain stimulation (DBS) programming in Parkinson's disease (PD) requires a complex process for evaluating clinical benefit and adverse effects. Localizing maximum beta (13-30Hz) power may guide DBS programming. Novel use of in-clinic unipolar recording may improve the efficacy of neurophysiology-guided DBS programming.
Objective:
Compare the contact selection and clinical outcomes based upon either maximum beta power from unipolar recordings or standard-of-care monopolar review at initial programming in PD.
Methods:
Ten PD patients (4F/6M, post-diagnosis = 9.2 ± 3.5 years; on/off percent change = 43.7 ± 14.0) with bilateral subthalamic nucleus (STN) DBS were recruited. For each hemisphere, contacts selected by maximum beta power from unipolar recordings or monopolar clinical assessments were compared based upon therapeutic window (TW), MDS-UPDRS Part III for unilateral symptoms, and the time to complete these two conditions.
Results:
Change from baseline in TW and MDS-UPDRS Part III outcomes did not differ between DBS programming based upon unipolar recordings and monopolar review, nor were there differences in sub-analysis for bradykinesia, rigidity, and tremor. Time efficiency in contact selection was greater for unipolar recordings compared with monopolar assessment (p = 3.6e-15). Follow-up comparison between unipolar and bipolar recordings to determine the location of maximum beta power revealed that 85% of the unipolar contacts were one of the bipolar recording pairs.
Conclusion:
This study further supports the use of neurophysiology, specifically unipolar recordings of beta power, to inform initial programming with evidence of efficiency and clinical efficacy.
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