Objective: To investigate the role of local field potential (LFP) recordings as biomarkers of dystonia severity in patients with pallidal deep brain stimulation (DBS) systems capable of chronic sensing.
Background: Dystonia is a movement disorder characterized by involuntary muscle contractions [1], affecting ~16/100,000 individuals globally [2]. DBS can significantly reduce dystonia symptoms, yet absence of an established biomarker limits programming and clinical management [3-6]. LFP features recorded through commercial DBS systems could potentially represent informative biomarkers of dystonia severity [7-15] and guide DBS programming and clinical decision making.
Method: Globus pallidus internus (GPi) LFP recordings were collected in 2 modalities from 10 patients with early-onset dystonia and analyzed retrospectively after informed consent. BrainSense Survey (90s, stimulation OFF) data were collected from 10 individuals assessed using the Burke–Fahn–Marsden Dystonia Rating Scale (BFMDRS) Movement subscale. Survey spectra were compared with 6 pediatric non-Huntington’s-chorea (GPi DBS) and 5 adult Parkinson Disease (PD) cases [16] to compare differences in power spectral density (PSD) across distinct movement disorders. BrainSense Timeline (chronic sensing, stimulation ON) were analyzed in 5 cases with clinically meaningful (≥16.6%; denoting minimum BFM-based clinically important changes [17]) dystonia severity reductions between sessions. Data were analyzed using custom MATLAB(2023b) scripts.
Results: Survey analyses of dystonia cases reveal increased LFP PSDs in the theta, alpha, and low beta frequencies [figure1]. However, PSD magnitude and pattern across frequency bands differ from chorea(p=0.017, KS test) and PD(p=0.03). Comparing Survey with BFMDRS suggests correlation between power across canonical frequency bands and dystonia severity [figure2](median q=0.0290, BH FDR). However, cross-session Survey data showed no consistent correlation with severity scores (data not shown). Timeline data enabled longitudinal assessment of delayed clinical responses to programming not captured by Surveys [figure3]. Decreased LFP power aligned with lower dystonia severity in 9/10 instances, paralleling clinical improvements between sessions.
Conclusion: Together, these findings show that distinct GPi LFP features putatively reflect dystonia severity across sensing modalities and over time, supporting their potential ability to guide dystonia DBS programming.
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Figure3
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To cite this abstract in AMA style:
P. Bisarad, A. Shrestha, K. Shivaram, H. Magee, R. Gelineau-Morel, C. Gorodetsky, S. Hallgren, A. Hewitt, G. Ibrahim, J. Kelbert, T. Larsh, N. Lucente, J. O'Malley, M. Pascual, S. Wu, F. Ponce, J. Hauptman, D. Kern, J. Thompson, M. Kruer. Characterizing Local Field Potentials in Early-Onset Dystonia [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/characterizing-local-field-potentials-in-early-onset-dystonia/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/characterizing-local-field-potentials-in-early-onset-dystonia/