Temporal Dynamics of Beta Power Related to the Stun Effect in Parkinson's Disease Patients after Deep Brain Stimulation Surgery

Background: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an effective treatment for patients with advanced Parkinson's disease (PD). Early programming of DBS may be complicated by the postoperative “stun effect,” which also may impact local field potentials (LFPs). Methods: Percept PC neurostimulators (Medtronic) were used to continuously record LFPs from the STN in 32 PD patients at home during the first 2 months after DBS surgery. Average beta peak power (“beta power”) per day was analyzed using change-point analysis. Results: Median beta power across patients showed an upward trend with a changepoint 24 to 40 days after surgery. Median beta power directly following DBS activation did not significantly drop but continued to increase beyond the DBS activation visit. Conclusion: The neurophysiological stun effect persists for at least 3 weeks and should be taken into consideration when timing and applying sensing-informed or adaptive DBS based on beta power.