We aim to characterize the prevalence of peaks in the power spectral density of the local field potentials (LFPs) of patients with primary dystonia treated with deep brain stimulation (DBS).

DBS is an effective therapy for medication refractory primary dystonia. DBS programming for dystonia is challenging due to the lack of real-time visual feedback and the delayed therapeutic response. There is emerging evidence that LFP analysis can guide this process.

We conducted a retrospective study of patients with primary dystonia who underwent bilateral globus pallidus internus (GPi) DBS with a sensing-enabled system (Medtronic Percept). LFP recordings were collected in the clinic setting in the DBS OFF state while patients were at rest. We define the spectral bands using the canonical definitions: beta from 12 Hz to 30 Hz and gamma from 30 to 100 Hz. Spectral band powers were extracted using the UF BRAVO platform with visual-based frequency peak detection. Descriptive statistics were performed to characterize frequency distribution and trends over time.

51 subjects (28 female, 23 male) with dystonia and GPi DBS were included for analysis. 28 (54.9%) demonstrated a beta band peak and 23 (45.1%) demonstrated a gamma band peak at any point during DBS programming. 29 participants had longitudinal recordings which demonstrated persistent beta peaks in 22 (75.8%) and persistent gamma peaks in 16 (55.2%). Additionally, 20.7% initially had no beta peak and later developed one, 27.6% had a beta peak that disappeared over time, and 27.6% had both. 34.5% initially had no gamma peak and later developed one, 13.8% had a gamma peak that disappeared over time and 6.9% had both.

We provide an overview of basal ganglia electrophysiology in a large cohort of primary dystonia patients treated with DBS. Further research is needed to identify potential biomarkers that could guide neuromodulation strategies.