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However, the biomarkers of REM disturbances remain unknown, leading to the lack of REM\u2010specific neuromodulation interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aims to investigate the neurophysiological biomarkers of REM disturbance in parkinsonian patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Ten PD patients implanted with bilateral subthalamic nucleus\u2010deep brain stimulation (STN\u2010DBS) were included in this study, of whom 4 were diagnosed with RBD. Sleep monitoring was conducted 1\u2009month after surgery. Subthalamic local field potentials (LFP) were recorded through sensing\u2010enabled DBS. The neurophysiological features of subthalamic LFP during phasic and tonic microstates of REM sleep and their correlation with REM sleep fragmentation and RBD were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Differences in subthalamic \u03b3 oscillation between phasic and tonic REM correlated positively with the severity of REM sleep fragmentation. Patients with RBD also exhibited stronger \u03b3 oscillations during REM sleep compared with non\u2010RBD patients, and both increased \u03b2 and \u03b3 were found before the onset of RBD episodes. Stimulation changes in simulated \u03b3\u2010triggered feedback modulation followed more closely with phasic REM density, whereas an opposite trend was found in simulated \u03b2\u2010triggered feedback modulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Excess subthalamic \u03b3 oscillations may contribute to REM instability and RBD, suggesting that \u03b3 oscillation could serve as a feedback signal for adaptive DBS for REM sleep disorders. \u00a9 2024 The Author(s).\n                      <jats:italic>Movement Disorders<\/jats:italic>\n                      published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.\n                    <\/jats:p>\n                  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