Association of low-frequency oscillations with target selection between the subthalamic nucleus and globus pallidus...

Stimulation of the subthalamic nucleus (STN) and globus pallidus internus (GPi) is an effective target for treating blepharospasm-oromandibular dystonia, but the individual optimal remains unclear.

Thirteen patients with blepharospasm-oromandibular dystonia were enrolled. Bilateral STN and GPi electrodes were implanted and externalized, and the signal of the two targets was recorded simultaneously. The power spectrum and burst characteristics were analyzed to see how they were related to symptom severity.

The 1 year follow-up revealed an overall improvement rate of 76.21% ± 12.51%. Those with GPi as final targets showed higher band power and longer average burst duration in the 5.5-12 Hz band in the GPi compared to the STN (P < 0.05). Conversely, those with STN as final targets showed higher band power and longer average burst duration in the 6-10 Hz band in the STN compared to the GPi (P < 0.05). Exclusion of shorter low-frequency bursts led to higher correlation coefficients with BFMDRS-M scores in both the STN and GPi groups (P < 0.01).

Our study suggests that low-frequency oscillatory features may be associated with therapeutic target selection for DBS in blepharospasm-oromandibular dystonia. These findings may help inform target selection strategies and warrant prospective validation for their value in supporting long-term clinical outcomes.