Local Field Potentials in Movement Disorders: A Narrative Review

Background: Local field potentials (LFPs) represent the summed electrical activity of neuronal populations and provide a critical window into synaptic and oscillatory dynamics across brain networks. In recent decades, advances in deep brain stimulation (DBS) and chronic sensing technology have established LFPs as essential biomarkers for understanding movement disorders and optimizing neuromodulation therapies. Summary: This review synthesizes evidence on LFPs in movement disorders, focusing on methodological aspects, functional characterization, disease-specific findings, and clinical applications. In Parkinson's disease (PD), exaggerated beta-band activity in the subthalamic nucleus and globus pallidus internus (GPi) correlates with bradykinesia and rigidity, while dyskinesias are linked to broadband gamma activity and disrupted cross-frequency coupling. Essential tremor (ET) shows tremor-frequency synchronization in the thalamus and related networks. In dystonia, theta and alpha oscillations in the GPi correlate with symptom severity and guide DBS targeting. Tics in Tourette syndrome involve thalamic low-frequency oscillations, while chorea in Huntington's disease is associated with elevated beta-gamma power. Clinically, LFPs are increasingly used for intraoperative targeting, postoperative programming, outpatient monitoring, and as biomarkers for adaptive DBS (aDBS). Key Messages: LFPs provide fundamental insights into disease-specific neural oscillations across PD, ET, dystonia, tics, and chorea. Pathological patterns serve as reliable biomarkers of symptom states. By leveraging these signals, DBS can be more accurately targeted, programming can be streamlined, and long-term outpatient monitoring can be enhanced. aDBS based on LFP biomarkers is already in clinical use for PD, offering superior motor control and fewer side effects than conventional stimulation.