Objective: To define distinct clinical roles of beta- and gamma-band local field potential (LFP) biomarkers in chronic deep brain stimulation (DBS) for Parkinson’s disease (PD) and their programming implications.

Background: Sensing-enabled DBS allows chronic stimulation-on LFP recording, yet programming remains empirical. Beta (13-30 Hz) and gamma (>30 Hz) oscillations are proposed as control signals, but their relative value for severity tracking and stimulation-on state decoding remains unclear.

Method: PRISMA 2020-guided searches (January 2020-October 2025) identified English-language human studies of chronic STN/GPi LFPs quantitatively linked to validated outcomes. Intra- and peri-operative-only recordings were excluded. Risk of bias was assessed using RoB 2 and the Newcastle-Ottawa Scale. Heterogeneity in biomarker subtypes, stimulation states and endpoints precluded meta-analysis; findings were synthesised narratively by programming domain.

Results: Twenty-seven studies were included. Beta biomarkers robustly indexed hypokinetic severity and treatment response: bradykinesia correlated with beta power and burst duration (β≈−0.48 to −0.53), and low-beta explained up to 49% of velocity variance (R²=0.49). Beta suppression tracked motor improvement (R up to 0.666), and beta burst–driven adaptive DBS showed large within-subject effects (ηp²=0.74). Under therapeutic stimulation, gamma subtypes (stimulation-entrained gamma and finely tuned gamma, FTG) more reliably tracked dopaminergic “ON” state and motor fluctuations, supporting adaptive control (AUC 0.70–0.89). In decoding models, adding beta features provided minimal incremental discrimination (AUC 0.74 to 0.75). Dyskinesia effects were subtype-specific: levodopa-linked narrowband gamma/FTG correlated with severity (ρ up to 0.53), whereas absence of entrained gamma predicted dyskinetic epochs (AUC 0.69–0.77). Non-motor evidence was limited; one study linked gamma, but not beta, to rapid eye movement (REM) sleep fragmentation.

Conclusion: Chronic postoperative evidence demonstrates functional dissociation: beta indexes impairment magnitude and treatment response, whereas gamma (entrained/FTG) supports stimulation-on state decoding and dyskinesia-aware adaptive control, supporting mechanism-informed, multi-feature programming frameworks for next-generation DBS.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/beta-and-gamma-local-field-potentials-in-chronic-deep-brain-stimulation-for-parkinsons-disease-programming-implications-from-a-systematic-review/