Subthalamic oscillations and phase amplitude coupling are greater in the more affected hemisphere in Parkinson's disease

•Parkinson's neural oscillations and coupling were greater in the more affected STN and were evident in 98% cases.•Positive correlation between frequencies of beta and HFO at maximum PAC strength.•Alpha/beta band power was lower in the tremor dominant phenotype and was attenuated by emergent tremor.

ObjectiveDetermine the incidence of resting state oscillations in alpha/beta, high frequency (HFO) bands, and their phase amplitude coupling (PAC) in a large cohort in Parkinson's disease (PD).MethodsIntra-operative local field potentials (LFPs) from subthalamic nucleus (STN) were recorded from 100 PD subjects, data from 74 subjects were included in the analysis.ResultsAlpha/beta oscillations were evident in >99%, HFO in 87% and PAC in 98% of cases. Alpha/beta oscillations (P < 0.01) and PAC were stronger in the more affected (MA) hemisphere (P = 0.03). Alpha/beta oscillations were primarily found in 13-20 Hz (low beta). Beta and HFO frequencies with the greatest coupling, were positively correlated (P = 0.001). Tremor attenuated alpha (P = 0.002) and beta band oscillations (P < 0.001).ConclusionsSTN alpha/beta band oscillations and PAC were evident in ⩾98% cases and were greater in MA hemisphere. Resting tremor attenuated underlying alpha/beta band oscillations.SignificanceBeta band LFP power may be used to drive adaptive deep brain stimulation (aDBS), augmented by a kinematic classifier in tremor dominant PD.