Initial Case Series of a Novel Sensing Deep Brain Stimulation Device in Drug-Resistant Epilepsy and Consistent Identification of Alpha/Beta Oscillatory Activity
Abstract number :
2.053
Submission category :
3. Neurophysiology / 3E. Brain Stimulation
Year :
2023
Submission ID :
410
Source :
www.aesnet.org
Presentation date :
12/3/2023 12:00:00 AM
Published date :
Authors :
First Author: Melissa Chua, MD – Brigham and Women's Hospital
Presenting Author: John Rolston, MD, PhD – Brigham & Women's Hospital, Harvard Medical School
Matteo Vissani, PhD – Massachusetts General Hospital; David Liu, MD – Brigham and Women's Hospital; Frederic Schaper, MD – Brigham and Women's Hospital; Aaron Warren, PhD – Brigham and Women's Hospital; Rose Caston, PhD – University of Utah; Barbara Dworetzky, MD – Brigham and Women's Hospital; Ellen Bubrick, MD – Brigham and Women's Hospital; Rani Sarkis, MD – Brigham and Women's Hospital; Garth Cosgrove, MD, FRCSC – Brigham and Women's Hospital; John Rolston, MD, PhD – Brigham and Women's Hospital
Rationale:
Novel deep brain stimulation (DBS) devices are capable of recording local field potentials (LFP). Disease states such as Parkinson’s Disease have revealed electrophysiological biomarkers with suppression of specific frequency oscillations being associated with improvement in symptoms. We report a retrospective, single-center experience with a novel DBS device capable of chronic LFP recording in drug-resistant epilepsy (DRE) and explore potential electrophysiological biomarkers that may aid DBS programming and outcome tracking.
Methods:
Five patients with DRE underwent thalamic DBS, targeting either the bilateral anterior (ANT; n=3) or centromedian (CM; n=2) nuclei. Postoperative electrode lead localizations were performed and visualized in Lead-DBS software. Local field potentials recorded over 12-18 months were tracked and changes in power were associated with patient events, medication changes, and stimulation. We utilize a combination of lead localization, in-clinic broadband LFP recordings, real-time LFP response to stimulation, and chronic recordings to guide DBS programming.
Results:
Four patients (80%) experienced a >50% reduction in seizure frequency (Engel class 1D, IIIA, IIIA, IIIA), while one patient had no significant reduction (Engel class IVB). Peaks in the alpha and/or beta frequency range were observed in the thalamic LFPs of each patient. Stimulation suppressed these LFP peaks in a dose-dependent manner. Chronic timeline data identified changes in LFP amplitude associated with stimulation, seizure occurrences, and medication changes. We also noticed circadian pattern of LFP amplitudes in all patients. Button-presses during seizure events via a mobile application served as a digital seizure diary and were associated with elevations in LFP power.
Conclusions:
We describe an initial cohort of patients with DRE with a novel sensing DBS device and characterize potential LFP biomarkers of epilepsy that may be associated with seizure control after DBS in DRE. We also present a new workflow utilizing the Percept device that may optimize DBS programming using real-time and chronic LFP recording.
Funding: None
Neurophysiology