000 03292 am a22003853u 4500
042 _adc
100 1 0 _aShah, Ashesh
_eauthor
_92791
700 1 0 _aNguyen, Thuy-Anh Khoa
_eauthor
_92792
700 1 0 _aPeterman, Katrin
_eauthor
_92793
700 1 0 _aKhawaldeh, Saed
_eauthor
_92794
700 1 0 _aDebove, Ines
_eauthor
_92795
700 1 0 _aShah, Syed Ahmar
_eauthor
_92796
700 1 0 _aTorrecillos, Flavie
_eauthor
700 1 0 _aTan, Huiling
_eauthor
700 1 0 _aPogosyan, Alek
_eauthor
700 1 0 _aLachenmayer, Martin Lenard
_eauthor
_92800
700 1 0 _aMichelis, Joan
_eauthor
_92801
700 1 0 _aBrown, Peter
_eauthor
_92802
700 1 0 _aPollo, Claudio
_eauthor
_92803
700 1 0 _aKrack, Paul
_eauthor
_92804
700 1 0 _aNowacki, Andreas
_eauthor
_92805
700 1 0 _aTinkhauser, Gerd
_eauthor
_92806
245 0 0 _aCombining Multimodal Biomarkers to Guide Deep Brain Stimulation Programming in Parkinson Disease
260 _c2022-02-23.
500 _a/pmc/articles/PMC7614142/
500 _a/pubmed/35219571
520 _aBACKGROUND: 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.
540 _a
540 _ahttps://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/).
546 _aen
690 _aArticle
655 7 _aText
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786 0 _nNeuromodulation
856 4 1 _uhttp://dx.doi.org/10.1016/j.neurom.2022.01.017
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999 _c959
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