Effect of frequency on dual target deep brain stimulation

Area of Science:

• Neuromodulation
• Neuroscience
• Biomedical Engineering

Background:

• Deep brain stimulation (DBS) is a key treatment for Parkinson's disease (PD) motor symptoms.
• Dual target deep brain stimulation (DT DBS) offers potential for improved symptom reduction and side effect management compared to single-target DBS.
• Optimal parameters for DT DBS remain largely undetermined.

Purpose of the Study:

• To investigate the frequency response of DT DBS on bradykinesia and beta oscillations in Parkinson's disease.
• To explore the use of intrahemispheric pulse delay shifts to minimize energy consumption in DT DBS.
• To identify optimal stimulation parameters for DT DBS.

Main Methods:

• DT DBS was applied to six participants with Parkinson's disease using the Summit RC+S device.
• DBS frequency was systematically varied to assess its effects on motor symptoms and neural oscillations.
• A biophysical model was utilized to further examine frequency effects and explore intrahemispheric delay strategies.

Main Results:

• DT DBS at 50 Hz demonstrated efficacy in reducing bradykinesia.
• Increasing DT DBS frequency up to 125 Hz resulted in significant reductions in beta power, a biomarker for PD motor symptoms.
• A biophysical model predicted that 22 Hz DT DBS with a 40 ms intrahemispheric delay could achieve an 87% reduction in beta power.

Conclusions:

• This exploratory study suggests that 125 Hz DT DBS may be most effective for reducing bradykinesia in Parkinson's disease.
• Tailored low-frequency DT DBS, incorporating intrahemispheric delays, shows promise for achieving comparable symptomatic control.
• Both high-frequency (125 Hz) and optimized low-frequency DT DBS strategies may offer equivalent therapeutic benefits for Parkinson's disease symptoms.