Objective: Characterize changes in Subthalamic Nucleus local field potential (STN LFP) activity related to stages of the sleep-wake cycle.

Background: Deep brain stimulation (DBS) devices used for the treatment of Parkinson’s disease (PD), are designed to emit a constant electrical pulse train with stimulation parameters—including voltage, frequency, and pulse width—determined by clinicians. Efforts to increase the efficacy of stimulation systems have focused on developing feedback control devices that can self-determine optimal stimulation parameters, based on real-time patient-derived physiologic input. Modulating stimulation parameters in response to LFPs recorded from macroelectrode DBS contacts has shown promising preliminary results.¹  Rigorous characterization of LFP is crucial to providing additional spectral markers that developers of feedback control devices can use to gate stimulation to. Here we provide detailed characterization of changes in LFP over the course of nighttime polysomnography, in ten PD patients implanted with DBS targeting STN .

Methods: PD patients (n=10) in the “off” medication state underwent STN LFP recording with concurrent polysomnography for a full night (6-9 hours). LFP were recorded through an externalized DBS lead three weeks after implantation.² Kruskal-Wallis non-parametric ANOVA with post-hoc Bonferroni correction was applied to determine statistical significance.

Results: We report on the spectral power of STN LFP frequency bands 0-3, 3-7, 7-13, 13-30, 30-90, 90-200, and 200-350 Hz, relative to changes in polysomnograph-determined arousal or sleep state (awake with movement, awake without movement, REM, N1, N2, N3). Novel findings include: (1) significantly (p<0.0001) greater 3-7 Hz median bandpower in REM, N1, N2, and N3 relative to either awake with movement or awake without movement in group analysis, and (2) significant (p<0.0001) median bandpower differences in N1, N2, and N3 compared to REM, awake with movement, and awake without movement were reported for bands (0-3 Hz), (3-7 Hz), (7-13 Hz), (13-30 Hz) and (30-90 Hz).

Conclusions: Our findings suggest that STN LFP may be used to differentiate between awake versus sleep states, which holds significant potential for the creation of closed-loop DBS devices.

References: 1.         Little S, Pogosyan A, Neal S, et al. Adaptive deep brain stimulation in advanced Parkinson disease. Ann Neurol 2013;74(3):449-457.

2.         Abosch A, Lanctin D, Onaran I, Eberly L, Spaniol M, Ince NF. Long-term recordings of local field potentials from implanted deep brain stimulation electrodes. Neurosurgery 2012;71(4):804-814.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/subthalamic-nucleus-local-field-potential-activity-during-the-sleep-wake-cycle/