Objective: to investigate the relationship between pallidal activity and clinical response to deep brain stimulation (DBS) of the globus pallidus internus (GPi)
Background: GPi-DBS is a mainstay treatment for medically refractory dystonia, but clinical outcomes can vary significantly. The factors that predict response to DBS remain unclear, also due to our limited understanding of the neural dynamics underlying dystonia pathophysiology. New DBS devices allow the recording of neural activity with chronically implanted electrodes, providing insights into basal ganglia functioning and paving the way for the development of personalized neuromodulation strategies.
Method: We recorded bilateral pallidal local field potentials (LFP) of eight dystonic patients with GPi-DBS during rest, under chronic stimulation (stim-on), and after switching off stimulation for at least 30 minutes (stim-off). To reduce motion artifacts, synchronous muscular and kinematic recordings of dystonic tremor were regressed out from the LFP signals. Cardiac artifacts were mitigated using a singular value decomposition analysis based on cardiac peaks detected from heart rate monitoring, while stimulation artifacts in the stim-on condition were eliminated using the Period-based Artifact Reconstruction and Removal Method (PARRM). We compared the power spectral densities (PSDs) of the cleaned signals between stim-off and stim-on conditions and correlated them with the severity of dystonia and clinical improvement after surgery, and its percentual variation between pre- and post-DBS.
Results: We observed a suppression by GPi-DBS of power in the alpha (8-12 Hz) and low-beta (13-20 Hz) bands. DBS-induced relative power decrease positively correlated with clinical improvement after surgery in both bands (Pearson’s ρ, alpha band = 0.79, beta band = 0.85, p < 0.05).
Conclusion: Our findings suggest that the clinical benefit of GPi-DBS in dystonia patients is linked to a reduction in alpha- and low-beta pallidal activity. Further research on larger cohorts is warranted to define the potential of these biomarkers for the development of novel and more effective adaptive DBS strategies.
To cite this abstract in AMA style:
C. Palmisano, J. Del Vecchio, I. Hanafi, A. Al Habbal, C. Matthies, G. Pezzoli, J. Volkmann, P. Capetian, N. Pozzi, S. Haufe, I. Isaias. Clinical Improvement after Deep Brain Stimulation is associated with the Suppression of Pallidal low-frequency Oscillations in Patients with Dystonia [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/clinical-improvement-after-deep-brain-stimulation-is-associated-with-the-suppression-of-pallidal-low-frequency-oscillations-in-patients-with-dystonia/. Accessed October 5, 2025.« Back to 2025 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-improvement-after-deep-brain-stimulation-is-associated-with-the-suppression-of-pallidal-low-frequency-oscillations-in-patients-with-dystonia/