TY  - JOUR
A1  - Binder, Tobias
A1  - Lange, Florian
A1  - Pozzi, Nicolò
A1  - Musacchio, Thomas
A1  - Daniels, Christine
A1  - Odorfer, Thorsten
A1  - Fricke, Patrick
A1  - Matthies, Cordula
A1  - Volkmann, Jens
A1  - Capetian, Philipp
T1  - Feasibility of local field potential-guided programming for deep brain stimulation in Parkinson’s disease: a comparison with clinical and neuro-imaging guided approaches in a randomized, controlled pilot trial
JF  - Brain Stimulation
N2  - Highlights
• Beta-Guided programming is an innovative approach that may streamline the programming process for PD patients with STN DBS.
• While preliminary findings from our study suggest that Beta Titration may potentially mitigate STN overstimulation and enhance symptom control,
• Our results demonstrate that beta-guided programming significantly reduces programming time, suggesting it could be efficiently integrated into routine clinical practice using a commercially available patient programmer.

Background
Subthalamic nucleus deep brain stimulation (STN-DBS) is an effective treatment for advanced Parkinson's disease (PD). Clinical outcomes after DBS can be limited by poor programming, which remains a clinically driven, lengthy and iterative process. Electrophysiological recordings in PD patients undergoing STN-DBS have shown an association between STN spectral power in the beta frequency band (beta power) and the severity of clinical symptoms. New commercially-available DBS devices now enable the recording of STN beta oscillations in chronically-implanted PD patients, thereby allowing investigation into the use of beta power as a biomarker for DBS programming.

Objective
To determine the potential advantages of beta-guided DBS programming over clinically and image-guided programming in terms of clinical efficacy and programming time.

Methods
We conducted a randomized, blinded, three-arm, crossover clinical trial in eight Parkinson's patients with STN-DBS who were evaluated three months after DBS surgery. We compared clinical efficacy and time required for each DBS programming paradigm, as well as DBS parameters and total energy delivered between the three strategies (beta-, clinically- and image-guided).

Results
All three programming methods showed similar clinical efficacy, but the time needed for programming was significantly shorter for beta- and image-guided programming compared to clinically-guided programming (p < 0.001).

Conclusion
Beta-guided programming may be a useful and more efficient approach to DBS programming in Parkinson's patients with STN-DBS. It takes significantly less time to program than traditional clinically-based programming, while providing similar symptom control. In addition, it is readily available within the clinical DBS programmer, making it a valuable tool for improving current clinical practice.
KW  - beta power
KW  - deep brain stimulation
KW  - local field potentials
KW  - Parkinson's disease
KW  - DBS programming
KW  - DBS biomarkers
Y1  - 2023
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-350280
VL  - 16
IS  - 5
ER  -