Stimulus-evoked directional field potentials to guide subthalamic and pallidal DBS for PD

Parkinson’s disease and other movement disorders are by far the most common indications for deep brain stimulation (DBS) worldwide. Despite intense and ongoing investigation, there are no established biomarkers to identify optimal stimulation locations and parameters with increasingly complex directional and adaptive DBS devices. Here we will collaborate with our industry partner Boston Scientific to pioneer use of their novel 16- contact directional Argyle lead, informed by their emerging stimulation and recording architecture, NEXT (Neuromodulation Experimental Testbed). We will use advanced experimental and analytic methods to generate detailed spatiotemporal maps of stimulus-evoked electrophysiology in the subthalamic nucleus versus globus pallidus interna in patients with Parkinson’s disease, both awake and under general anesthesia. We will then create predictive models from these spatial maps to guide directional DBS activation and clinical programming. Our overall goal is to pair our novel analytic methods with emerging device technologies to develop predictive biomarkers to guide directional DBS therapy for Parkinson’s disease and other complex neurocognitive disorders. Our vision, and that of our industry collaborator, is for next-generation DBS devices to integrate these technologies into fully implanted devices that can reveal crucial interactions between DBS and human brain circuits to guide clinical decision-making at the point of care during both surgical targeting and clinical programming.