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Case Reports
. 2022 Mar 10:7:103-106.
doi: 10.1016/j.cnp.2022.03.002. eCollection 2022.

Thalamic local field potentials recorded using the deep brain stimulation pulse generator

A W G Buijink  1 , D A Piña-Fuentes  1 , M J Stam  1 , M Bot  2 , P R Schuurman  2 , P van den Munckhof  2 , A F van Rootselaar  1 , R M A de Bie  1 , M Beudel  1
Affiliations
Case Reports

Thalamic local field potentials recorded using the deep brain stimulation pulse generator

A W G Buijink et al. Clin Neurophysiol Pract. .

Abstract

Background: Essential tremor (ET) is one of the most common movement disorders, and continuous deep brain stimulation (DBS) is an established treatment for medication-refractory cases. However, the need for increasing stimulation intensities, with unpleasant side effects, and DBS tolerance over time can be problematic. The advent of novel DBS devices now provides the opportunity to longitudinally record LFPs using the implanted pulse generator, which opens up possibilities to implement adaptive DBS algorithms in a real-life setting.

Methods: Here we report a case of thalamic LFP activity recorded using a commercially available sensing-enabled DBS pulse generator (Medtronic Percept PC).

Results: In the OFF-stimulation condition, a peak tremor frequency of 3.8 Hz was identified during tremor evoking movements as assessed by video and accelerometers. Activity at the same and supraharmonic frequency was seen in the frequency spectrum of the LFP data from the left vim nucleus during motor tasks. Coherence analysis showed that peripherally recorded tremor was coherent with the LFP signal at the tremor frequency and supraharmonic frequency.

Conclusion: This is the first report of recorded tremor-related thalamic activity using the electrodes and pulse generator of an implanted DBS system. Larger studies are needed to evaluate the clinical potential of these fully implantable systems, and ultimately pulse generators with sensing-coupled algorithms driving stimulation, to really close the loop.

Keywords: Adaptive; Closed-loop; Deep brain stimulation; Essential tremor; Tremor.

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Figures

Fig. 1
Fig. 1
A. Spectrogram of the LFP of the left Vim nucleus with stimulation at 0.0 mA (OFF), tremor activity around 4 Hz is visible throughout the experimental protocol. B. Spectrogram of the dominant accelerometer axis. C. Cross spectral analysis (coherence) of the left Vim and right arm during stretching of the right arm showing significant cortico-kinematic coherence around the tremor frequency and its harmonics. D. Three-dimensional reconstruction of the DBS leads localized in MNI space using Lead-DBS software (Horn et al., 2019). Recording electrode contacts are highlighted in red. Vim = ventral intermediate nucleus (based on the DISTAL atlas (Ewert et al., 2018)), nd-DRTT = non-decussating dentatorubrothalamic tract (based on the DBS Tractography Atlas (Middlebrooks et al., 2020). (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)
See this image and copyright information in PMC

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