Prediction of pathological subthalamic nucleus beta burst occurrence in Parkinson's disease

The cortico-basal ganglia network in Parkinsons disease (PD) is characterized by the emergence of transient episodes of exaggerated beta frequency oscillatory synchrony known as bursts. Although it is well established that bursts of prolonged duration associate closely with motor impairments, the mechanisms leading to burst initiation remain poorly understood. Crucially, it is unclear whether there are features of basal ganglia activity which reliably predict burst onset. Current adaptive Deep Brain Stimulation (aDBS) approaches can only reactively deliver stimulation following burst detection and are unable to stimulate proactively to prevent burst onset. The discovery of predictive biomarkers could allow for such proactive stimulation, thereby offering potential for improvements in therapeutic efficacy. Here, using deep learning, we show that the timing of subthalamic nucleus (STN) beta bursts can be accurately predicted up to 60 ms prior to onset. Furthermore, we highlight that a dip in the beta amplitude - which is likely to be indicative of a phase reset of oscillatory populations occurring between 80-100 ms prior to burst onset - is a predictive biomarker for burst occurrence. These findings demonstrate proof-of-principle for the feasibility of beta burst prediction for DBS and provide insights into the mechanisms of burst initiation.