Objective: To evaluate the relationship between 10-minute averaged beta-band local field potential (LFP) activity recorded from implanted deep brain stimulation (DBS) systems and motor state fluctuations in daily-life conditions with a validate wearable device.

Background: Beta-band activity (13–35 Hz) recorded from the subthalamic nucleus has been proposed as a neurophysiological marker of motor impairment in Parkinson’s disease (PD) and is currently explored as a feedback signal in adaptive DBS. Most supporting evidence, however, derives from short-term or in-clinic recordings. The extent to which long-term averaged beta activity reflects real-world motor states remains to be clarified.

Method: In this retrospective pilot study, six patients with PD implanted with sensing-enabled DBS systems were analyzed under no-stimulation conditions. Ten-minute averaged beta-band LFP power was temporally aligned with objective motor state estimates obtained using STAT-ON, a validated wearable system for continuous monitoring of motor symptoms in PD [1]. STAT-ON–derived bradykinesia classification served as the reference motor state label in 10-minute windows. Patient-level analyses included receiver operating characteristic (ROC) curves and non-parametric statistical comparisons between ON and OFF states.

Results: Across six patients, beta activity showed substantial inter-individual and inter-hemispheric variability. Circadian modulation was observed, with median relative day–night beta power reductions of −13.1% in the left hemisphere and −21.0% in the right hemisphere. When aligned with objectively defined motor states, discriminative performance was heterogeneous. Only one patient reached a moderate classification performance (AUC = 0.69), while the remaining patients did not demonstrate consistent discrimination between ON and OFF states using 10-minute averaged beta power. At the group level, no robust separation of motor states was observed.

Conclusion: In this pilot real-world cohort, 10-minute averaged beta-band LFP activity showed limited and heterogeneous association with objectively defined motor states. Although circadian modulation was observed, discrimination between ON and OFF states was not robust at the group level. Larger cohorts and complementary approaches are needed to better define its role in adaptive DBS.

References: 1. Rodríguez-Martín D, Cabestany J, Pérez-López C, Pie M, Calvet J, Samà A, et al. A New Paradigm in Parkinson’s Disease Evaluation With Wearable Medical Devices: A Review of STAT-ONTM. Front Neurol. 2022;13. doi:10.3389/fneur.2022.912343

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MDS Abstracts - https://www.mdsabstracts.org/abstract/real-world-relationship-between-beta-band-lfp-activity-and-motor-states-in-parkinsons-disease/