Evoked response signatures explain deep brain stimulation outcomes

Deep brain stimulation (DBS) is an established treatment for Parkinson’s disease. Still, DBS parameter programming currently follows a tedious trial-and-error process. DBS-evoked cortical potentials (EP) might guide parameter selection but this concept has not yet been tested. Further, mounting wet EEG systems is too time-consuming to scale in outpatient clinic settings. Here, we test the utility of a novel method that leverages the spatial pattern of EP using a dry EEG setup. We acquired EP in 58 hemispheres in patients with Parkinson’s disease and compute a model which represents the optimal EP response pattern associated with maximal clinical improvements. Once defined, we use this pattern to estimate stimulation outcomes in unseen patients. Finally, we utilize it to identify optimal stimulation contacts in five unseen hemispheres where it selected the correct contact in all cases. The simple setup makes this novel method an attractive option to guide DBS programming in clinical practice.