Objective: To describe the activity of the subthalamic nucleus (STN) during wake and sleep in patients with Parkinson’s disease (PD) with conventional (cDBS) or adaptive deep brain stimulation (aDBS).
Background: Increased beta power oscillations in the STN are a pathological hallmark of PD. However, their (patho-)physiological contribution to motor and non-motor tasks is still poorly understood. Suppression of subthalamic beta power oscillations during sleep has been described in PD patients both in off-stimulation and under cDBS, making it a potential biomarker for novel adaptive DBS paradigms. However, the impact of cDBS and aDBS on PD-related beta power fluctuations in the sleep-wake cycle is still unclear and may affect the clinical benefit differently in the two modes. Circadian oscillations of subthalamic activity are also important information for programming, especially in aDBS mode.
Method: We recruited ten patients with idiopathic PD who received subthalamic DBS and directional leads. Patients were treated with cDBS and aDBS for two weeks in each condition, in randomized order, and with unchanged drug therapy. In aDBS mode, our rechargeable fully implantable pulse generator applies a linear algorithm that changes the stimulation current every minute based on the average local field potential (LFP) amplitude calculated in a patient-specific beta frequency range. In both stimulation modes, we acquired STN-LFP spectra with 10-minute resolution, and calculated the amplitude in range of ±2 Hz around the most prominent beta peak.
Results: For all patients, beta peak frequency showed no significant changes in either stimulation mode (cDBS or aDBS) and patient state (awake or asleep). Beta power amplitude was significantly reduced during asleep compared to awake time in both stimulation modes. STN-LFP spectra showed no significant differences between cDBS and aDBS.
Conclusion: Our data show stability of patient-specific beta peaks and consistent modulation of subthalamic beta power during sleep-wake cycle with comparable impact of cDBS and aDBS. These results support the use of patient-specific beta peaks as a stable biomarker for aDBS and provide a valuable insight in the definition of beta power thresholds for aDBS programming.
To cite this abstract in AMA style:
L. Caffi, R. Habib, S. Bonvegna, M. Pilleri, G. Pezzoli, C. Palmisano, A. Mazzoni, IU. Isaias. Sleep-wake modulation of subthalamic activity in patients with Parkinson’s disease and conventional or adaptive deep brain stimulation [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/sleep-wake-modulation-of-subthalamic-activity-in-patients-with-parkinsons-disease-and-conventional-or-adaptive-deep-brain-stimulation/. Accessed October 5, 2025.« Back to 2025 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/sleep-wake-modulation-of-subthalamic-activity-in-patients-with-parkinsons-disease-and-conventional-or-adaptive-deep-brain-stimulation/