Periodic and aperiodic components of subthalamic nucleus activity
reflect different aspects of motor impairment in Parkinson's disease
Abstract
Excessive beta oscillations in the subthalamic nucleus are established
as a primary electrophysiological biomarker for motor impairment in
Parkinson’s disease and are currently used as feedback signals in
adaptive deep brain stimulation systems. However, there is still a need
for optimization of stimulation parameters and the identification of
optimal biomarkers that can accommodate varying patient conditions, such
as ON and OFF levodopa medication. The precise boundaries of
“pathological” oscillatory ranges, associated with different aspects
of motor impairment, are still not fully clarified. In this study, we
hypothesized that analyzing periodic and aperiodic components of
subthalamic nucleus activity separately and identifying functionally
distinct subranges within 8-35 Hz based on oscillatory properties may
reveal robust biomarkers for specific aspects of motor impairment. We
analyzed subthalamic nucleus activity of 14 patients with Parkinson’s
disease. Local field potentials were recorded at rest from externalized
electrodes postoperatively, both before and after levodopa
administration. We showed that levodopa administration suppressed
oscillations across a broad frequency range (11-32 Hz) and increased the
slope of the aperiodic component. Changes in the aperiodic slope
correlated with motor symptom alleviation. Periodic activity was linked
to motor symptom severity: peak amplitude within the 14-20 Hz range
correlated with overall motor impairment in the OFF state, while the
7-11 Hz range was associated with bradykinesia in the ON state. Our
findings suggest that, in addition to low beta, alpha oscillations and
the aperiodic component may serve as promising biomarkers for motor
impairment and potential feedback signals in adaptive DBS systems.