Objective: investigate electrophysiological patterns related to circadian rhythms, medication intake & long-term DBS effects.

Background: Deep brain stimulation (DBS) offers substantial and long-lasting motor improvements for PD. New DBS technologies enable a window into the local physiological activity, which might provide new clinical information during daily activities

Method: We collected longitudinal home-recorded data over 25-97 days from 4 patients ( 56.2±11.8 years; disease-duration: 10.5±4.8 years) with bilateral Medtronic Percept™ DBS devices. Clinical assessments were based on the UPDRS III. Long-term sensing was configured to monitor Local Field Potentials (LFPs) in the beta band. LFP data were acquired every 10 minutes, and patients used the remote to mark medication intake. Circadian patterns were explored using Welch’s power spectral density to create periodograms. The effects of medication on LFPs were assessed by comparing changes in LFP before and after medication intake. Long-term effects of DBS were evaluated by analysing the occurrence of periodic activity in the beta band (15-30 Hz), identified after accounting for the a-periodic component using the FOOOF (Fitting Oscillations & One-Over-F) method.

Results: Our findings revealed significant differences in mean power of the LFP activity in the beta range between day and night across all patients (p<0.0001). Sleep-related symptoms in one patient were observed to correlate to this cycle. Medication intake was followed by significantly reduced LFP levels one-hour post-intake (p < 0.001), with a gradual increase observed 2 hours later, although values remained lower than pre-intake levels. Finally, patient-specific analysis of neural activity around medication intake events revealed a significant reduction in the number of beta peaks from 1 month after surgery compared to those recorded 3+ months after surgery in Patient 1, alongside notable changes in aperiodic parameters. Patient 2 exhibited less pronounced alterations.

Conclusion: Future research into LFP signals and event-related spectral data holds great potential for providing clinicians with deeper insights into patients’ conditions.  Combining in-clinic assessments with real-time, long-term data will enhance our understanding of patient symptoms and well-being, paving the way for adaptive and personalized treatments.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/long-term-analysis-of-subthalamic-local-field-potentials-lfp-in-parkinsons-disease-insights-into-circadian-rhythms-medication-and-personalized-treatment-effects/