Recent advances in deep brain stimulation (DBS) devices have enabled the ability to capture continuous neural recordings concurrently with stimulation therapy in the background of everyday life. These recordings provide the opportunity to investigate neural biomarkers of various behaviors or clinical status. However, they are susceptible to artifacts that can obscure and limit our ability to interpret neural signals. In a cohort of 23 patients who underwent DBS for obsessive-compulsive disorder (OCD) with the Medtronic Percept device, we identified an artifact in longitudinal neural recordings that occurs when the detected voltage exceeds the device’s maximum sensing capabilities. When such an event occurs, the device inserts a flag value in the neural power stream. We found that overvoltage events are significantly more common in patients implanted with legacy Medtronic 3387 leads than those with newer Medtronic SenSight leads. We demonstrate a best practice, principled strategy for correcting samples affected by overvoltage events to preserve the ability to analyze the data. Finally, in a subset of patients who wore an Oura Ring concurrently with neural recordings (N=14), we found that overvoltage events were more likely during physical activity, suggesting that movement artifacts may elevate low-frequency power regardless of lead model.

B.M.K. has performed contracted research with Abbott Laboratories for the TRANSCEND study and consulted for Lykos Therapeutics. B.J.M. has received research support from Health Rhythms, LivaNova, Compass Pathways, and Abbott; and consulting fees from Inside Edge, VML, Atheneum, Guidepoint, Kx Advisors, and S2N Health. S.A.S. is the co-founder of Motif Neurotech and has consulted with Boston Scientific, Zimmer Biomet, Koh Young, and Neuropace.

This research was supported by the National Institutes of Health (NIH) National Institute of Neurological Disorders and Stroke BRAIN Initiative via contract UH3NS136631 (to S.A.S., W.K.G., J.A.H., N.R.P.), the McNair Foundation (S.A.S., N.R.P.) and the Gordon and Mary Cain Pediatric Neurology Research Foundation (S.A.S.).

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

All procedures were approved by the local institutional review board (IRB) at the Baylor College of Medicine (BCM; IRB H-48392, IRB H-56119) and the University of Utah (IRB_00169174).

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* We are grateful to the patients and their families for their involvement in the research program. This research was supported by the National Institutes of Health (NIH) National Institute of Neurological Disorders and Stroke BRAIN Initiative via contract UH3NS136631 (to S.A.S., W.K.G., J.A.H., N.R.P.), the McNair Foundation (S.A.S., N.R.P.) and the Gordon and Mary Cain Pediatric Neurology Research Foundation (S.A.S.).

↵† E-mail: rick.hanishrice.edu

All data produced in the present study are available upon reasonable request to the authors.