Objective: To investigate subthalamic nucleus (STN) low-frequency dynamics during emotional engagement while watching live sports in patients with Parkinson’s disease treated with adaptive deep brain stimulation.

Background: Deep brain stimulation (DBS) of the STN treats advanced parkinson’s disease (PD). Adaptive DBS (aDBS) adjusts stimulation according to local field potential (LFP) amplitude within a patient-specific frequency band (P-range). Because the STN integrates motor, cognitive, and limbic information, it may encode emotional processes. Whether real-life emotional states appear in chronically recorded STN activity remains unclear.

Method: Eight patients with PD receiving chronic aDBS were studied. Bilateral STN LFP amplitude (nV/√Hz) was recorded within a patient-specific alpha–beta P-range (8–23 Hz) at 1-minute resolution during tennis and soccer matches. Post-viewing interviews classified periods as engaged (N=15) or neutral (N=13); engaged viewings were divided into higher- and lower-engagement intervals. Key events were identified from sports reports and verified by video. Each engaged viewing was compared with baseline day and control periods. Signals were separated into trend (30-minute mean) and detrended components; derivatives were estimated using Savitzky–Golay filtering. Associations between key events and detrended extrema were tested with permutation testing (10K iterations). Per-match comparisons used Mann-Whitney U with Benjamini-Hochberg correction; population-level analysis used Wilcoxon signed-rank with Cohen’s d.

Results: During engaged viewing, median P-range amplitude was higher than baseline day (left STN: p<0.05; right STN: p<0.01) and control periods (left: p<0.05; right: p<0.01). No differences occurred during neutral viewing. Higher-engagement intervals showed larger trend derivatives in the left STN (p<0.001; p<0.005) and more time above the 75th percentile. In six tennis viewings from one participant, key events coincided with detrended P-range extrema in the left STN (p<0.05).

Conclusion: STN low-frequency activity recorded in ecological conditions reflects emotional engagement beyond motor processing, suggesting markers for personalized adaptive stimulation.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/subthalamic-low-frequency-activity-reflects-engagement-during-live-sports-viewing/