Evaluating Thalamic Biomarkers for Closed-Loop Deep Brain Stimulation in Essential Tremor

Area of Science:

• Neuroscience
• Biomedical Engineering
• Neurological Disorders

Background:

• Deep brain stimulation (DBS) and local field potential (LFP) recordings are key for closed-loop systems in Essential Tremor (ET).
• Identifying reliable biomarkers for movement detection is crucial for adaptive DBS therapies.

Purpose of the Study:

• To evaluate LFP band power and inter-lead coherence as biomarkers for intended movement detection in an ET patient.
• To assess the potential of dual-lead thalamic recordings for closed-loop DBS applications.

Main Methods:

• Recorded LFPs from ventral intermediate (VIM) and ventralis-oralis (VO) nuclei using Medtronic Percept™ RC neurostimulator and SenSight electrodes.
• Patient performed Drink Cup and postural holding tasks, with simultaneous accelerometer data collection.
• Generalized linear models (GLMs) and ROC curves analyzed LFP data for movement onset decoding.

Main Results:

• Individual leads showed task- and band-specific performance (e.g., VIM in Delta for Drink Cup, VO in Beta for Posture).
• Integrating LFP data from both VO and VIM leads significantly enhanced movement detection performance (AUC > 0.71).
• VO lead LFP signals demonstrated potential as biomarkers for closed-loop DBS in ET.

Conclusions:

• This study is the first to show LFP signals from the thalamus's ventralis-oralis nucleus as a potential biomarker for closed-loop DBS in Essential Tremor.
• Integrating data from dual VO and VIM leads substantially improves movement detection.
• These findings support the development of more effective, adaptive closed-loop DBS for ET and other movement disorders.