Gimple, S. V.; Temel, Y.; Herff, C.; Janssen, M. L. F.

Background: Electrophysiological recordings from chronically implanted Deep Brain Stimulation (DBS) electrodes can greatly advance understanding of disease and treatment mechanisms of motor and psychiatric disorders. The Medtronic Percept system allows for chronic recordings of local field potentials (LFP) from DBS target regions. However, these systems lack an inbuilt synchronization option to align LFP recordings to other recording modalities and consequently events in computerized tasks. Objective: We propose and evaluate a synchronization method based on Transcutaneous Electrical Stimulation (TES) with low amplitudes to precisely align recorded LFP signals from the DBS electrodes to EEG recordings. Methods: The TES-based synchronization approach was implemented and tested in 11 participants implanted with the Medtronic Percept for treatment of Parkinson`s disease. Results: The proposed method provides high reliability, precise alignment and usability across all Medtronic Percept recording modes. Notably, the method enables recordings during adaptive DBS and with stimulation turned off. In this recording mode, LFP signals can be acquired from all recording contact pairs simultaneously, with a high signal-to-noise ratio. We provide detailed setup plans and share Python and Matlab scripts for signal alignment to enable easy application of our approach. Conclusion: By enabling reliable, well-aligned LFP recordings from all DBS contacts, our method provides a robust tool for studying neural dynamics and refining therapeutic interventions in diverse neurological conditions.