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Contrasting Effects of Deep Brain Stimulation and Intravenous Levodopa on Local Field Potentials.

Hikaru Kamo1,2, Jackson N Cagle1, Kara A Johnson1,3

  • 1Department of Neurology, Fixel Institute for Neurological Diseases, University of Florida, Gainesville, Florida, USA.

Movement Disorders : Official Journal of the Movement Disorder Society
|January 19, 2026
PubMed
Summary

Levodopa and subthalamic nucleus deep brain stimulation improve Parkinson's disease motor function by altering neural oscillations. Finely tuned gamma oscillations (FTG) show promise as a biomarker for effective treatment.

Keywords:
adaptive stimulationclosed‐loop neuromodulationneurophysiologyoscillatory biomarkerssubcortical dynamicstime–frequency analysis

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Area of Science:

  • Neuroscience
  • Neurology
  • Biomedical Engineering

Background:

  • Parkinson's disease (PD) is a neurodegenerative disorder affecting motor control.
  • Deep brain stimulation (DBS) and levodopa are common treatments for advanced PD.
  • Understanding their effects on neural activity is crucial for optimizing therapy.

Purpose of the Study:

  • To compare the effects of intravenous levodopa and subthalamic nucleus (STN) DBS on neural oscillations and motor function in PD patients.
  • To investigate the relationship between specific oscillatory patterns and motor improvement.

Main Methods:

  • A within-patient study involving 12 advanced PD patients with implanted STN electrodes.
  • Five conditions were tested: medication/stimulation off, placebo, medication on, stimulation on, and combined therapy.
  • Local field potentials and motor function (UPDRS Part III) were recorded under each condition.

Main Results:

  • Both levodopa and STN DBS improved motor scores and reduced low beta activity.
  • High beta activity decreased only with stimulation.
  • Finely tuned gamma (FTG) oscillations emerged during combined therapy and correlated with motor improvement, unlike placebo effects.

Conclusions:

  • Levodopa and STN DBS have distinct yet complementary effects on neural oscillations.
  • FTG oscillations, not just beta power, reflect therapeutic state and motor improvement without dyskinesia.
  • FTG shows potential as a biomarker for adaptive DBS systems in Parkinson's disease.