Moreover, our results provide evidence supporting the clinical utility of M1 PAC as a reliable feedback biomarker in the development of symptom-specific adaptive DBS. In previous reports, cortical PAC in humans was almost exclusively recorded though ECoG in intraoperative settings17,56,57 or through high-density scalp EEG.58,59 While in both scenarios, a considerable extent of fixation/stationary is needed. It is understudied how PAC responds to and whether PAC can be measured during naturalistic movement.60 Our data demonstrate that although general movement (i.e. walking) significantly reduced PAC compared to resting, the reduced PAC still indicates pathological conditions and responses to therapeutic DBS. Notably, the results obtained in this study were based on PAC calculated in a 10-s window. In developing adaptive DBS, this slower control strategy, as opposed to the fast time scale burst-detecting strategy,61,62 may better track motor fluctuations over a period of time.63 The latest Summit RC + S (Medtronic) study64 employed a feedback time scale of 2–10 min in chronic at-home recordings. Longer data segment increases the signal-to-noise ratio helping better differentiate pathological from the physiological state, which may also
