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Combining Multimodal Biomarkers to Guide Deep Brain Stimulation Programming in Parkinson Disease.
Shah, Ashesh; Nguyen, Thuy-Anh Khoa; Peterman, Katrin; Khawaldeh, Saed; Debove, Ines; Shah, Syed Ahmar; Torrecillos, Flavie; Tan, Huiling; Pogosyan, Alek; Lachenmayer, Martin Lenard; Michelis, Joan; Brown, Peter; Pollo, Claudio; Krack, Paul; Nowacki, Andreas; Tinkhauser, Gerd.
Affiliation
  • Shah A; Department of Neurology, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Nguyen TK; Department of Neurosurgery, Bern University Hospital, University of Bern, Bern, Switzerland; ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.
  • Peterman K; Department of Neurology, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Khawaldeh S; MRC Brain Network Dynamics Unit, University of Oxford, Oxford, UK; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK; Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, Department of Psychiatry, University of Oxford, Oxford, UK.
  • Debove I; Department of Neurology, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Shah SA; Usher Institute, Edinburgh Medical School, The University of Edinburgh, Edinburgh, UK.
  • Torrecillos F; MRC Brain Network Dynamics Unit, University of Oxford, Oxford, UK; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
  • Tan H; MRC Brain Network Dynamics Unit, University of Oxford, Oxford, UK; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
  • Pogosyan A; MRC Brain Network Dynamics Unit, University of Oxford, Oxford, UK; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
  • Lachenmayer ML; Department of Neurology, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Michelis J; Department of Neurology, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Brown P; MRC Brain Network Dynamics Unit, University of Oxford, Oxford, UK; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
  • Pollo C; Department of Neurosurgery, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Krack P; Department of Neurology, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Nowacki A; Department of Neurosurgery, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Tinkhauser G; Department of Neurology, Bern University Hospital, University of Bern, Bern, Switzerland. Electronic address: gerd.tinkhauser@insel.ch.
Neuromodulation ; 26(2): 320-332, 2023 Feb.
Article in En | MEDLINE | ID: mdl-35219571
ABSTRACT

BACKGROUND:

Deep brain stimulation (DBS) programming of multicontact DBS leads relies on a very time-consuming manual screening procedure, and strategies to speed up this process are needed. Beta activity in subthalamic nucleus (STN) local field potentials (LFP) has been suggested as a promising marker to index optimal stimulation contacts in patients with Parkinson disease.

OBJECTIVE:

In this study, we investigate the advantage of algorithmic selection and combination of multiple resting and movement state features from STN LFPs and imaging markers to predict three relevant clinical DBS parameters (clinical efficacy, therapeutic window, side-effect threshold). MATERIALS AND

METHODS:

STN LFPs were recorded at rest and during voluntary movements from multicontact DBS leads in 27 hemispheres. Resting- and movement-state features from multiple frequency bands (alpha, low beta, high beta, gamma, fast gamma, high frequency oscillations [HFO]) were used to predict the clinical outcome parameters. Subanalyses included an anatomical stimulation sweet spot as an additional feature.

RESULTS:

Both resting- and movement-state features contributed to the prediction, with resting (fast) gamma activity, resting/movement-modulated beta activity, and movement-modulated HFO being most predictive. With the proposed algorithm, the best stimulation contact for the three clinical outcome parameters can be identified with a probability of almost 90% after considering half of the DBS lead contacts, and it outperforms the use of beta activity as single marker. The combination of electrophysiological and imaging markers can further improve the prediction.

CONCLUSION:

LFP-guided DBS programming based on algorithmic selection and combination of multiple electrophysiological and imaging markers can be an efficient approach to improve the clinical routine and outcome of DBS patients.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Parkinson Disease / Subthalamic Nucleus / Deep Brain Stimulation Type of study: Guideline / Prognostic_studies Limits: Humans Language: En Journal: Neuromodulation Year: 2023 Type: Article Affiliation country: Switzerland
Fulltext
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Parkinson Disease / Subthalamic Nucleus / Deep Brain Stimulation Type of study: Guideline / Prognostic_studies Limits: Humans Language: En Journal: Neuromodulation Year: 2023 Type: Article Affiliation country: Switzerland