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Mechanisms mediating dynamic changes in neural responses during deep brain stimulation.

Jahrane A Dale1, Stephen L Schmidt1, Kyle T Mitchell2

  • 1Department of Biomedical Engineering, Duke University, Durham, NC, 27708, USA.

Brain Stimulation
|December 12, 2025
PubMed
Summary

Short-term synaptic depression in cortical synapses onto subthalamic nucleus (STN) neurons explains dynamic changes in deep brain evoked potentials (DLEPs) during Parkinson's disease (PD) treatment. This finding is crucial for optimizing deep brain stimulation (DBS) programming.

Keywords:
Deep brain stimulationEvoked potentialsParkinson's diseaseSynaptic plasticity

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Area of Science:

  • Neuroscience
  • Computational Neuroscience
  • Biophysics

Background:

  • Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a treatment for Parkinson's disease (PD).
  • DBS generates local evoked potentials (DLEPs) reflecting neural activation, but their dynamic changes during continuous stimulation are poorly understood.
  • Understanding DLEP dynamics is critical for optimizing DBS programming and developing closed-loop control systems.

Purpose of the Study:

  • To elucidate the mechanisms underlying dynamic changes in DLEPs during continuous STN DBS.
  • To investigate the role of synaptic depression in mediating DLEP dynamics.
  • To explore the potential of DLEP dynamics as a biomarker for PD progression.

Main Methods:

  • Developed a biophysically realistic computational model incorporating short-term synaptic depletion.
  • Recorded DLEPs in naïve and virally transfected rat models.
  • Conducted a retrospective analysis of DLEP dynamics in 13 PD patients, correlating them with motor symptom severity.

Main Results:

  • A computational model indicated that synaptic depression, specifically synaptic vesicle depletion in cortical synapses onto STN neurons, causes dynamic changes in DLEP amplitude and latency.
  • Viral overexpression of endophilin A1 or alpha-synuclein in rat motor cortex altered DLEP dynamics, supporting the role of these synapses.
  • A correlation was found between changes in UPDRS-III scores and the time constant of DLEP amplitude in PD patients, suggesting DLEP dynamics as a potential biomarker.

Conclusions:

  • Short-term synaptic depression of cortical synapses projecting to STN neurons is the primary mechanism mediating DLEP dynamics during STN DBS.
  • These findings provide crucial insights into the neurophysiological effects of DBS in PD.
  • DLEP dynamics show promise as a biomarker for monitoring PD progression and informing DBS therapy.