Inconsistent subthalamic local field potential beta activity amid in- and antiphasic neuronal bursts

Elevated subthalamic (STN) beta (12–32 Hz) local field potentials (LFP) are a hallmark of Parkinson’s disease and closely tied to synchronized spiking. The biomarker guides deep brain stimulation (DBS) lead implantation and is under investigation to inform DBS programming and adaptive DBS, yet its prevalence has not been independently assessed. This study assesses the biomarkers prevalence and investigating its relationship to synchronized beta-bursting neurons.

STN LFPs and spiking activity of n = 156 patients with Parkinson’s disease from seven DBS centers recorded via microelectrodes were examined and spectral LFP peaks classified. The distribution of phase angles between beta LFP and beta-bursting neurons was explored. Beta LFPs were bilaterally expressed in 47.25% of patients (65.59% of hemispheres).

LFP-synchronized neuronal spiking clustered in two peaks, 182.84° phase shifted. This applied on the group level and for individual patients. Beta-LFP-informed approaches mandate reliable biomarker expression, a requirement not met by 52.75% of patients.

This is particularly troublesome for intraoperative guidance wherein the cause of biomarker absence, including DBS lead misplacement or a balanced ratio of phasic and antiphasic spiking neurons, cannot be determined. While STN-LFP beta remains a valuable biomarker, multiple biomarkers should be evaluated simultaneously to increase robustness. This work was supported by the Alexander von Humboldt Foundation (M.S.).

T.Ko. has been supported by the Munich Clinician Scientist Program (MCSP). Open Access funding enabled and organized by Projekt DEAL. These authors contributed equally: René Reese, Thomas Koeglsperger.

Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany Maximilian Scherer, Nina Wiedemann, Kai Bötzel & Thomas Koeglsperger Department of Neurology, Rostock University Medical Center, Rostock, Germany German Center for Neurodegenerative Diseases (DZNE) Rostock/Greifswald, Rostock, Germany Department of Neurosurgery, Rostock University Medical Center, Rostock, Germany Institute and Policlinic of Radiology, Pediatric Radiology and Neuroradiology, Rostock University Medical Center, Rostock, Germany Department of Neurosurgery, LMU University Hospital, LMU Munich, Munich, Germany Department of Translational Brain Research, German Center for Neurodegenerative Diseases (DZNE), Munich, Germany René Reese has received honoraria for presentations/advisory boards/travel expenses from Abbott, Boston Scientific, Esteve and Medtronic outside the present study. T.Ko. has received research funding from Medtronic and Abbott and speaker honoraria from Abbott and AbbVie. T.Ko. and R.R. serve as the president and vice-president of the German DBS Society (AG-THS).