Classification and Prediction of Clinical Improvement in Deep Brain Stimulation From Intraoperative Microelectrode Recordings

We present a random forest (RF) classification and regression technique to predict, intraoperatively, the unified Parkinson's disease rating scale (UPDRS) improvement after deep brain stimulation (DBS). We hypothesized that a data-informed combination of features extracted from intraoperative microelectrode recordings (MERs) can predict the motor improvement of Parkinson's disease patients undergoing DBS surgery. We modified the employed RFs to account for unbalanced datasets and multiple observations per patient, and showed, for the first time, that only five neurophysiologically interpretable MER signal features are sufficient for predicting UPDRS improvement. This finding suggests that subthalamic nucleus (STN) electrophysiological signal characteristics are strongly correlated to the extent of motor behavior improvement observed in STN-DBS.