Association of subthalamic beta frequency sub-bands to symptom severity in patients with Parkinson's disease: A systematic review

Objective Local field potentials (LFP), specifically beta (13–30Hz) frequency measures, have been found to be associated with motor dysfunction in people with Parkinson's disease (PwPD). A consensus on beta subband (low- and high-beta) relationships to clinical state or therapy response has yet to be determined. The objective of this review is to synthesize literature reporting the association of low- and high-beta characteristics to clinical ratings of motor symptoms in PwPD. Methods A systematic search of existing literature was completed using EMBASE. Articles which collected subthalamic nucleus (STN) LFPs using macroelectrodes in PwPD, analyzed low- (13–20 Hz) and high-beta (21–35 Hz) bands, collected UPDRS-III, and reported correlational strength or predictive capacity of LFPs to UPDRS-III scores. Results The initial search yielded 234 articles, with 11 articles achieving inclusion. Beta measures included power spectral density, peak characteristics, and burst characteristics. High-beta was a significant predictor of UPDRS-III responses to therapy in 5 (100%) articles. Low-beta was significantly associated with UPDRS-III total score in 3 (60%) articles. Low- and high-beta associations to UPDRS-III subscores were mixed. Conclusion This systematic review reinforces previous reports that beta band oscillatory measures demonstrate a consistent relationship to Parkinsonian motor symptoms and ability to predict motor response to therapy. Specifically, high-beta, demonstrated a consistent ability to predict UPDRS-III responses to common PD therapies, while low-beta measures were associated with general Parkinsonian symptom severity. Continued research is needed to determine which beta subband demonstrates the greatest association to motor symptom subtypes and potentially offers clinical utility toward LFP-guided DBS programming and adaptive DBS.