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We performed multi-night (n\u2009=\u200957) at-home intracranial recordings from electrocorticography and subcortical electrodes using sensing-enabled Deep Brain Stimulation (DBS), paired with portable polysomnography in four PD participants and one with cervical dystonia (clinical trial: NCT03582891). Cortico-basal activity in delta increased and in beta decreased during NREM (N2\u2009+\u2009N3) versus wakefulness in PD. DBS caused further elevation in cortical delta and decrease in alpha and low-beta compared to DBS OFF state. Our primary outcome demonstrated an inverse interaction between subcortical beta and cortical slow-wave during NREM. Our secondary outcome revealed subcortical beta increases prior to spontaneous awakenings in PD. We classified NREM vs. wakefulness with high accuracy in both traditional (30\u2009s: 92.6\u2009\u00b1\u20091.7%) and rapid (5\u2009s: 88.3\u2009\u00b1\u20092.1%) data epochs of intracranial signals. Our findings elucidate sleep neurophysiology and impacts of DBS on sleep in PD informing adaptive DBS for sleep dysfunction.<\/jats:p>","DOI":"10.1038\/s41467-024-46002-7","type":"journal-article","created":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T11:02:46Z","timestamp":1709031766000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Multi-night cortico-basal recordings reveal mechanisms of NREM slow-wave suppression and spontaneous awakenings in Parkinson\u2019s disease"],"prefix":"10.1038","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7981-4135","authenticated-orcid":false,"given":"Md Fahim","family":"Anjum","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clay","family":"Smyth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Zuzu\u00e1rregui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5314-1008","authenticated-orcid":false,"given":"Derk Jan","family":"Dijk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2733-4003","authenticated-orcid":false,"given":"Philip A.","family":"Starr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Denison","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6249-6230","authenticated-orcid":false,"given":"Simon","family":"Little","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,27]]},"reference":[{"key":"46002_CR1","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/j.expneurol.2012.08.018","volume":"243","author":"A Videnovic","year":"2013","unstructured":"Videnovic, A. & Golombek, D. 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T.D. is founder-chairman of MINT neurotechnology, founder\/CSO of Amber Therapeutics (bioelectronic medicines), and a paid advisor for Cortec Neuro. T.D. has research collaborations with Magstim Ltd, Medtronic, and Bioinduction Ltd. S.L., C.S., P.S., M.F.A, and T.D. are involved in a pending patent application. Patent applicant: University of California San Francisco (UCSF); Inventors: S.L., C.S., P.S., M.F.A., and T.D.; Application number: 63\/522,284; Status: Provisional; Specific aspect: Awakening detection and intracranial machine learning models for detection of awakenings.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1793"}}