Christmas‐Related Reduction in Beta Activity in Parkinson's Disease

Abstract

Background Subthalamic nucleus (STN) beta (13 ‐ 35 Hz) activity is a biomarker reflecting motor state in Parkinson's disease (PD). Adaptive deep brain stimulation (DBS) aims to use beta activity for therapeutic adjustments, but many aspects of beta activity in real‐life situations are unknown. Objective The aim was to investigate Christmas‐related influences on beta activity in PD. Methods Differences in Christmas Day to nonfestive daily averages in chronic biomarker recordings in 4 PD patients with a sensing‐enabled STN DBS implant were retrospectively analyzed. Sweet‐spot and whole‐brain network connectomic analyses were performed. Results Beta activity was significantly reduced on Christmas Eve in all patients (4.00–9.00 p.m.: −12.30 ± 10.78%, P = 0.015). A sweet spot in the dorsolateral STN connected recording sites to motor, premotor, and supplementary motor cortices. Conclusions We demonstrate that festive events can reduce beta biomarker activity. We conclude that circadian and holiday‐related changes should be considered when tailoring adaptive DBS algorithms to patient demands. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

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“…By not measuring the state of the brain before stimulation, we might not have captured the full impact of tDCS effects. This limitation should be considered when interpreting our results and could be addressed in future research by (99)(100)(101). Consequently, the variability in our results could be a side-effect of circadian rhythm fluctuations.…”

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“…21,67 Here, a particular focus should be put on long-term monitoring of brain signals outside of the clinic. 68,69 Further refinement of biomarker characterization outside the clinic should use objective symptom tracking, ecological momentary assessments, medication-intake logging, and "snapshot" tools to collect spectral characteristics of defined clinical states. 1 Ultimately, open access biomarker libraries should be established in which symptomspecific feedback signals are collected and validated to facilitate informed aDBS programming.…”

“…1). 21,67 Here, a particular focus should be put on long‐term monitoring of brain signals outside of the clinic 68,69 . Further refinement of biomarker characterization outside the clinic should use objective symptom tracking, ecological momentary assessments, medication‐intake logging, and “snapshot” tools to collect spectral characteristics of defined clinical states 1 .…”