Objective: We sought to explore associations between basal ganglia aperiodic signals and time since deep brain stimulation (DBS) implantation in children and young adults with dystonia.

Background: Recent advances in DBS devices allow for the recording of local field potentials (LFP) in the clinical setting. LFPs represent the summation of periodic and aperiodic signals, with most prior reports focusing on periodic signals. The aperiodic signal has been suggested to be related to the balance of excitatory and inhibitory neurons, with increased aperiodic signal associated with increase in inhibitory activity.

Method: During standard clinic visits, we collected LFP data from pediatric and young adults with the Percept PC (Medtronic, USA) neurostimulator. Data was collected using the BrainSense Survey function, with the subject at rest. Time between DBS implantation and clinic visit was noted.  LFP data was analyzed using MATLAB and FieldTrip open-source toolbox. The Irregular-Resampling Auto-Spectral Analysis (IRASA) method was used to separate aperiodic and oscillatory components in the power spectrum of LFPs in log-log space. We then quantified the spectral offset (intercept) and spectral exponent (negative slope magnitude) from the linear regression parameters of the IRASA-decomposed aperiodic spectrum. Linear regression modeling was used to assess effects of time since DBS implantation on aperiodic activity (spectral offset and spectral exponent), considering within-subject effects.

Results: Six pediatric and young adults were included (mean age at implantation: 17.3, range: 7.9-27.7). There was a total of 43 LFP recordings available for analysis (35 GPi, 8 STN). Mean time since DBS implantation was 16.3 months (range: 1.6-70.3). Overall, basal ganglia aperiodic activity decreased with time since DBS implantation (spectral offset: p = 0.02; spectral exponent: p = 0.006). However, this varied within individual subjects and appeared to differ between children and young adults.

Conclusion: We found basal ganglia aperiodic activity tended to decrease with time since DBS implantation, indicating more basal ganglia excitation. This was not universal across subjects and may differ between children and young adults. Factors that may have contributed to this finding include changes in plasticity induced by DBS, dystonia, and neurodevelopmental processes.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/deep-brain-stimulation-duration-and-changes-in-basal-ganglia-excitatory-inhibitory-balance-in-children-and-young-adults-with-dystonia/