{"doi":"10.1101/2025.10.11.25337803","title":"Characterization of beat frequency artifacts in dual-device deep brain stimulation","abstract":"Abstract Objective Recording-capable deep brain stimulation systems enable chronic monitoring of neural activity concurrently with stimulation. DBS configurations with two implantable pulse generators (IPGs) are becoming more common to increase the number of sensing and stimulating channels. However, even when both IPGs are programmed to the same stimulation frequency, slight mismatches IPG clock rate can cause deviations in true stimulation frequency across IPGs. These timing discrepancies create high amplitude “beat frequency artifacts” (BFAs) at regular intervals, complicating the interpretation of neural data. This study aimed to characterize the occurrence and timing of BFAs in dual-IPG systems and determine their relationship to differences in stimulation frequency. Approach In one patient, we intentionally created a DBS frequency mismatch by stimulating at different frequencies across the two IPGs. In a cohort of 26 patients, we quantified BFA intervals in LFP recordings during which stimulation frequencies were set to identical values on both IPGs during both continuous and adaptive stimulation modes. Main Results We observed a predictable relationship between BFAs and stimulation frequency and found that BFAs occurred at a rate of 1/Δ frequency , such that greater differences in DBS frequency resulted in more frequent artifacts. Even when both IPGs were set to the same stimulation frequency, BFAs occurred for all patients. During continuous DBS, artifact intervals ranged from 112 seconds to 30 minutes across the cohort of 26 patients. In a single patient, adaptive DBS (aDBS) mode shortened BFA intervals, suggesting that the transition to adaptive mode may influence the timing relationship between IPGs. Significance Recording neural activity during concurrent stimulation from two DBS devices leads to unique artifacts that may be caused by small discrepancies in effective stimulation frequency arising from independent device clocks. The interval between artifacts is predictable based on the DBS frequency mismatch, and may be exacerbated in certain stimulation modes, including aDBS.","journal":"medRxiv","year":2025,"id":577740,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9472,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1369249,"name":"Kara N. Presbrey","orcid":"0000-0003-3479-071X","position":1,"is_corresponding":false},{"id":305993,"name":"Stephanie Cernera","orcid":"0000-0002-6885-6791","position":3,"is_corresponding":false},{"id":1286140,"name":"Sameer Rajesh","orcid":"0009-0002-9533-6692","position":4,"is_corresponding":false},{"id":1180807,"name":"Raphael Bechtold","orcid":null,"position":5,"is_corresponding":false},{"id":1004908,"name":"Nisha Giridharan","orcid":"0000-0002-0142-1013","position":6,"is_corresponding":false},{"id":724452,"name":"Garrett P. Banks","orcid":"0000-0001-6292-977X","position":7,"is_corresponding":false},{"id":303752,"name":"Eric A. Storch","orcid":"0000-0002-7631-3703","position":8,"is_corresponding":false},{"id":301728,"name":"Doris D. Wang","orcid":"0000-0001-6112-3002","position":9,"is_corresponding":false},{"id":238119,"name":"Philip A. Starr","orcid":"0000-0003-2733-4003","position":10,"is_corresponding":false},{"id":430990,"name":"Wayne K. Goodman","orcid":"0000-0001-6717-082X","position":11,"is_corresponding":false},{"id":682464,"name":"Jeffrey A. Herron","orcid":"0000-0002-9813-0094","position":12,"is_corresponding":false},{"id":240427,"name":"Sameer A. Sheth","orcid":"0000-0001-8770-8965","position":13,"is_corresponding":false},{"id":560662,"name":"Nicole R. Provenza","orcid":"0000-0002-6952-5417","position":14,"is_corresponding":false},{"id":1286528,"name":"Nabeel Diab","orcid":null,"position":0,"is_corresponding":true}],"reference_count":21,"raw_metadata":null,"created_at":"2026-07-19T02:58:16.148027Z","pmid":"41282906","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}