biostudies-literatureZhang GRosetrees’ Trust, UKMedical Research CouncilNational Natural Science Foundation of ChinaKey R&amp;D Program of China1112-1122https://www.ebi.ac.uk/biostudies/studies/S-EPMC7616489biostudies-literatureUnknown95(12)<h4>Background</h4>Sleep fragmentation is a persistent problem throughout the course of Parkinson's disease (PD). However, the related neurophysiological patterns and the underlying mechanisms remained unclear.<h4>Method</h4>We recorded subthalamic nucleus (STN) local field potentials (LFPs) using deep brain stimulation (DBS) with real-time wireless recording capacity from 13 patients with PD undergoing a one-night polysomnography recording, 1 month after DBS surgery before initial programming and when the patients were off-medication. The STN LFP features that characterised different sleep stages, correlated with arousal and sleep fragmentation index, and preceded stage transitions during N2 and REM sleep were analysed.<h4>Results</h4>Both beta and low gamma oscillations in non-rapid eye movement (NREM) sleep increased with the severity of sleep disturbance (arousal index (ArI)-beta_NREM: r=0.9, p=0.0001, sleep fragmentation index (SFI)-beta_NREM: r=0.6, p=0.0301; SFI-gamma_NREM: r=0.6, p=0.0324). We next examined the low-to-high power ratio (LHPR), which was the power ratio of theta oscillations to beta and low gamma oscillations, and found it to be an indicator of sleep fragmentation (ArI-LHPR_NREM: r=-0.8, p=0.0053; ArI-LHPR_REM: r=-0.6, p=0.0373; SFI-LHPR_NREM: r=-0.7, p=0.0204; SFI-LHPR_REM: r=-0.6, p=0.0428). In addition, long beta bursts (>0.25 s) during NREM stage 2 were found preceding the completion of transition to stages with more cortical activities (towards Wake/N1/REM compared with towards N3 (p<0.01)) and negatively correlated with STN spindles, which were detected in STN LFPs with peak frequency distinguishable from long beta bursts (STN spindle: 11.5 Hz, STN long beta bursts: 23.8 Hz), in occupation during NREM sleep (β=-0.24, p<0.001).<h4>Conclusion</h4>Features of STN LFPs help explain neurophysiological mechanisms underlying sleep fragmentations in PD, which can inform new intervention for sleep dysfunction.<h4>Trial registration number</h4>NCT02937727.Journal of neurology, neurosurgery, and psychiatryNeurophysiological features of STN LFP underlying sleep fragmentation in Parkinson's disease.PMC7616489N/A815279012022YFC2405100MC_UU_00003/2Zhang GZhang JGTan HGuo YLi LYu HYin GGong CZhang YXu SChen YHao HYuan XfalseNeurophysiological features of STN LFP underlying sleep fragmentation in Parkinson's disease.<h4>Background</h4>Sleep fragmentation is a persistent problem throughout the course of Parkinson's disease (PD). However, the related neurophysiological patterns and the underlying mechanisms remained unclear.<h4>Method</h4>We recorded subthalamic nucleus (STN) local field potentials (LFPs) using deep brain stimulation (DBS) with real-time wireless recording capacity from 13 patients with PD undergoing a one-night polysomnography recording, 1 month after DBS surgery before initial programming and when the patients were off-medication. The STN LFP features that characterised different sleep stages, correlated with arousal and sleep fragmentation index, and preceded stage transitions during N2 and REM sleep were analysed.<h4>Results</h4>Both beta and low gamma oscillations in non-rapid eye movement (NREM) sleep increased with the severity of sleep disturbance (arousal index (ArI)-beta_NREM: r=0.9, p=0.0001, sleep fragmentation index (SFI)-beta_NREM: r=0.6, p=0.0301; SFI-gamma_NREM: r=0.6, p=0.0324). We next examined the low-to-high power ratio (LHPR), which was the power ratio of theta oscillations to beta and low gamma oscillations, and found it to be an indicator of sleep fragmentation (ArI-LHPR_NREM: r=-0.8, p=0.0053; ArI-LHPR_REM: r=-0.6, p=0.0373; SFI-LHPR_NREM: r=-0.7, p=0.0204; SFI-LHPR_REM: r=-0.6, p=0.0428). In addition, long beta bursts (>0.25 s) during NREM stage 2 were found preceding the completion of transition to stages with more cortical activities (towards Wake/N1/REM compared with towards N3 (p<0.01)) and negatively correlated with STN spindles, which were detected in STN LFPs with peak frequency distinguishable from long beta bursts (STN spindle: 11.5 Hz, STN long beta bursts: 23.8 Hz), in occupation during NREM sleep (β=-0.24, p<0.001).<h4>Conclusion</h4>Features of STN LFPs help explain neurophysiological mechanisms underlying sleep fragmentations in PD, which can inform new intervention for sleep dysfunction.<h4>Trial registration number</h4>NCT02937727.2024-01-01T00:00:00Z2024 Nov2026-06-03T05:20:07.785Z2026-05-28T03:07:29.296ZS-EPMC76164893872423110.1136/jnnp-2023-331979