Despite the clinical use as a Deep Brain Stimulation (DBS) target in Parkinson’s disease (PD) and recent approval for adaptive stimulation, beta dynamics in the Globus Pallidus internus (GPi) remain poorly defined compared to the Subthalamic Nucleus (STN). We investigated target-specific beta activity in Local Field Potentials recorded in PD patients implanted with sensing-enabled STN- or GPi-DBS and examined differential modulation by L-Dopa and stimulation and relationship with motor symptoms. In the untreated state, spectral profiles were comparable between targets.
L-Dopa selectively reduced low-beta power and burst durations in the STN, while suppressing high-beta activity in the GPi. DBS induced broadband beta suppression and burst shortening in the STN, whereas attenuated pallidal high-beta oscillations. Clinical improvement correlated with low-beta modulation in STN patients and high-beta modulation in GPi patients.
Low- and high-beta sub-bands exhibit distinct target-specific pathophysiological behaviour and responsiveness. These findings provide a physiological framework for frequency-tailored adaptive DBS. The authors received no specific funding for this work.
Padova Neuroscience Center (PNC), University of Padua, Padua, Italy Valentina D’Onofrio, Andrea Landi, Camillo Porcaro & Andrea Guerra Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland Gerd Tinkhauser, Elena Bernasconi & Alberto Averna Department of Neuroscience, University of Padua, Padua, Italy Dario Ciprietti, Laura Ludovica Grassi, Sofia Pavan, Camillo Porcaro & Andrea Guerra Academic Neurosurgery, Department of Neuroscience, University of Padua, Padua, Italy Institute of Cognitive Sciences and Technologies (ISTC) - National Research Council (CNR), Rome, Italy Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK Neurodegenerative Disease Unit, Department of Neuroscience, Padova Neuroscience Centre (PNC), University of Padua, Padua, Italy Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Camillo Hospital, Lido di Venezia, Venice, Italy The authors declare the following competing interests: G.T. received financial support from Boston Scientific and Medtronic, not related to the present work. G.T., A.Av. and E.B. receive funding from the Swiss National Science Foundation (project number: PZ00P3_202166), not related to the present work. G.T. and A.Av. received funding from the Swiss Parkinson Association.
A.A. has received honoraria/consultation fees from AbbVie, Bial, Bayer, Stada, Covantec, Ever Pharma, Medscape, Roche, Theravance Biopharma, UCB, and Zambon, not related to the present work. A.A. has also received funding from Horizon 2020 - Ministry of University and Research (MIR), Ministry of Health (MOH), European Union - NextGenerationEU – NRRP M6C2 - Investment: 2.1 “Enhancement and strengthening of biomedical research within the NSH", not related to the present work. A.G. has received compensation for consultancy and speaker-related activities from Bial, Zambon, STADA; he receives funding from the European Union “Next Generation EU, Mission 4 Component 1, Project code: P20223HHZ8, CUP: C53D23008440001”, not related to the present work.
The other authors do not have competing interests to declare. Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material.
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