case_images: PMC8414587_01
case_images: (a) Computed tomography scan with deep brain stimulation (DBS) electrodes (b) Beta band oscillation was detected in the left subthalamic nucleus (STN) (16.6 Hz with 1.20 muVp) and in the right STN (1.72 muVp) during the med-off/stim-off phase. The Movement Disorder Society revision of the United Parkinson's Rating Scale (MDS-UPDRS) score was 27 points.
case_images: fnhum-15-702961-g0001.jpg
case_images: PMC8414587_01_fnhum-15-702961-g0001.jpg
case_images: F1
case_images: After these evaluations, he consented to undergo STN-DBS with Percept PC (Medtronic, Inc., Minneapolis, MN) (Figure 1a). The MDS-UPDRS motor score was 27 points during med-off/stim-off, and the LFP intensity values were 1.20 muVp and 1.72 muVp in the left and right STN, respectively (Figure 1b).
case_images: Stimulation amplitude of adaptive deep brain stimulation (aDBS) and fluctuations in the beta band (16.60 +- 2.5 Hz) oscillation of the local field potential (LFP) over time for a long period (a) and a short period (b). Arrow in (b) indicates the timing of levodopa 100 mg /carbidopa 25 mg intake. Conventional DBS (cDBS) (outside the hospital): Stimulation was set at 2.2 mA. aDBS (inside and outside the hospital): Upper stimulation was set at 3.5 mA and lower at 0.7 mA. Strength of beta oscillation = Vin (v) * Gain * 16 (LSB) / 1.2 (v) Vin: input voltage to the analog to digital convertor, Gain = 250, LSB of an analog-to-digital convertor is 16 least significant bits, The analog-to-digital convertor has a voltage range of 1.2 v.
case_images: fnhum-15-702961-g0002.jpg
case_images: PMC8414587_01_fnhum-15-702961-g0002.jpg
case_images: F2
case_images: Conversely, the percentage exceeding the beta upper threshold was 73%, that below the threshold was 15%, and that between the threshold was 12% in the non-hospital setting, while the stimulation successfully adapted to the fluctuations of LFP during the aDBS phase (Figure 2).
case_images: Clinical course of the patient.
case_images: fnhum-15-702961-g0003.jpg
case_images: PMC8414587_01_fnhum-15-702961-g0003.jpg
case_images: F3
case_images: The clinical course is summarized in Figure 3.