Abstract
Deep brain stimulation is an effective treatment for Parkinson's disease, but clinical programming remains subjective and time-consuming. Neurophysiological biomarkers may offer an objective and scalable approach to guide stimulation settings. To examine whether cortical oscillations-particularly in alpha, beta, and narrowband gamma bands-reflect deep brain stimulation parameter changes and their dependency on the stimulating contact location. Thirteen Parkinson's patients with subthalamic deep brain stimulation (21 hemispheres) underwent electroencephalography during routine programming sessions. Arm-task segments across multiple stimulation amplitudes were analysed. Alpha (8-12 Hz), beta (13-30 Hz), and narrowband gamma (60-90 Hz) power and burst features were extracted from the ipsilateral motor cortex. Volumes of tissue activated were computed and overlapped with the motor subthalamic nucleus to assess stimulation targeting. Relationships between neurophysiological features, stimulation amplitude, motor subthalamic-nucleus overlap, and active contact location were evaluated.
Cortical alpha burst amplitude and duration significantly decreased with stimulation amplitude-but only when active contacts were located within the motor subthalamic-nucleus. Cortical beta-band features showed no significant modulation across amplitudes or locations. Cortical narrowband gamma power and burst rate increased with stimulation amplitude, especially when stimulation overlapped with the motor subthalamic-nucleus, though effects were less spatially specific than for alpha. Cortical alpha and narrowband gamma oscillations provide sensitive and complementary physiomarkers of deep brain stimulation parameter change. Alpha dynamics reflect spatially precise stimulation within the motor subthalamic-nucleus, while narrowband gamma scales with amplitude. These features may support EEG-guided programming and future adaptive deep brain stimulation strategies.