Objective: To investigate the characteristics of local field potentials (LFPs) associated with the STN region that elicit stimulation-induced dyskinesia (SID) in PD patients.

Background: Approximately 50% of PD patients undergoing STN-DBS develop SID, which predicts favorable clinical outcomes, and SID-inducing contacts are often the most effective electrode contacts for long-term therapy; however, the underlying neural mechanisms remain uncertain.

Method: We retrospectively analyzed intraoperative LFP recordings of 21 PD patients, categorizing them based on SID occurrence. Bipolar LFPs were divided into: SID-LFP from SID-inducing contacts, nSID-LFP from contacts not eliciting SID within the SID group, and NSID-LFP from the non-SID group. We compared beta and gamma powers across these groups and assessed their correlation. The UPDRS-III was monitored before surgery and at the 6-month follow-up. The DBS settings that produced the maximum clinical benefit at the 6-month follow-up are summarized.

Results: SIDs were elicited in 47.6% of patients, and 30 contacts across 16 electrodes were identified as SID-inducing contacts. No significant differences in the clinical characteristics were observed between both groups (p>0.05). Nevertheless, it is noteworthy that SID-inducing contacts were utilized to obtain the maximum clinical benefit for all 16 electrodes at the 6-month follow-up. The power of the finely tuned gamma (FTG) oscillations in the SID-LFP group was significantly lower than that in the other two groups (p<0.01); however, no significant differences were found in the beta and low-gamma oscillations (p>0.05). Furthermore, a significant negative correlation was observed between low beta power and FTG power in all three groups (p<0.01), and significant negative correlations between high beta power and FTG power were observed in the nSID-LFP and NSID-LFP groups (p<0.01). However, no negative correlation was observed in the SID-LFP group (p>0.05).

Conclusion: SID-inducing contacts optimized the outcomes of STN-DBS in patients with PD. Our findings demonstrate the presence of abnormal LFP oscillations in the SID-inducing region within the STN, which may be biomarkers for identifying SID-inducing contacts, providing insights for the identification of an effective stimulation site for STN-DBS in patients with PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/abnormal-subthalamic-oscillations-as-potential-biomarkers-for-identifying-the-dyskinesia-inducing-region-within-the-subthalamic-nucleus-in-parkinsons-disease/