title: Directional Recording of Subthalamic Spectral Power Densities in Parkinson's Disease and the Effect of Steering Deep Brain Stimulation.
abstract: BACKGROUND
  A new 32-contacts deep brain stimulation (DBS) lead, capable of directionally steering stimulation, was tested intraoperatively.
  
  
  OBJECTIVE
  The aim of this pilot study was to perform recordings from the multidirectional contacts and to investigate the effect of directional current steering on the local field potentials (LFPs).
  
  
  METHODS
  In eight patients with Parkinson's disease, after standard microelectrode recording and clinical testing, the new lead was temporarily implanted. The 32-channel LFP recordings were measured simultaneously at different depths and directions before and after directional stimulation.
  
  
  RESULTS
  The spatial distribution of LFPs power spectral densities across the contact array at baseline marked the borders of the subthalamic nucleus (STN) with a significant increase in beta power and with a mean accuracy of approximately 0.6 mm in four patients.The power in the 18.5-30 Hz frequency band varied across different directions in all patients. In the three cases that showed improvement of rigidity, this was higher when current was steered toward the direction with the highest LFP power in the beta band. Subthalamic LFPs in six patients showed a differential frequency-dependent suppression/enhancement of the oscillatory activity in the 10-45 Hz frequency band after four different 'steering' modes as compared to ring mode, suggesting a higher specificity.
  
  
  CONCLUSIONS
  Through a new 32-contact DBS lead it is possible to record simultaneous subthalamic LFPs at different depths and directions, providing confirmation of adequate lead placement and multidirectional spatial-temporal information potentially related to pathological subthalamic electrical activity and to the effect of stimulation. Although further research is needed, this may improve the efficiency of steering stimulation.
authors.affiliation: Department of Neurology and Clinical Neurophysiology, Academic Medical Center, University of Amsterdam, the Netherlands. Electronic address: Bour@amc.nl.
authors.forename: L J
authors.initials: LJ
authors.lastname: Bour
authors.affiliation: Department of Neurology and Clinical Neurophysiology, Academic Medical Center, University of Amsterdam, the Netherlands.
authors.forename: M A J
authors.initials: MA
authors.lastname: Lourens
authors.affiliation: Department of Neurology and Clinical Neurophysiology, Academic Medical Center, University of Amsterdam, the Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Verhagen
authors.affiliation: Department of Neurology and Clinical Neurophysiology, Academic Medical Center, University of Amsterdam, the Netherlands.
authors.forename: R M A
authors.initials: RM
authors.lastname: de Bie
authors.affiliation: Department of Neurosurgery, Academic Medical Center, University of Amsterdam, the Netherlands.
authors.forename: P
authors.initials: P
authors.lastname: van den Munckhof
authors.affiliation: Department of Neurosurgery, Academic Medical Center, University of Amsterdam, the Netherlands.
authors.forename: P R
authors.initials: PR
authors.lastname: Schuurman
authors.affiliation: Department of Neurology and Clinical Neurophysiology, Academic Medical Center, University of Amsterdam, the Netherlands; Department of Neurology, Haga Teaching Hospital, the Hague, the Netherlands. Electronic address: m.f.contarino@amc.uva.nl.
authors.forename: M F
authors.initials: MF
authors.lastname: Contarino
mesh_terms: D058256:Brain Waves / Q000502:physiology*; D046690:Deep Brain Stimulation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000503:physiopathology*; D010865:Pilot Projects; D017603:Signal Detection, Psychological / Q000502:physiology; D020531:Subthalamic Nucleus / Q000502:physiology*
keywords: Local field potentials; New 32-contact DBS lead; Spectral analysis; Subthalamic nucleus