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Motor evoked potentials as a side effect biomarker for deep brain stimulation.

Paola Testini1, Austin Wang2, Eric R Cole3

  • 1Department of Neurology, University of Utah, 729 Arapeen Drive, Salt Lake City, UT 84105, United States.

Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology
|December 27, 2025
PubMed
Summary

Motor evoked potentials (MEP) can identify subclinical corticobulbar and corticospinal tract activation during deep brain stimulation (DBS). This biomarker aids in detecting motor side effects in Parkinson's disease patients.

Keywords:
Corticobulbar tractCorticospinal tractParkinson’s diseasesurface EMG

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Area of Science:

  • Neuroscience
  • Biomedical Engineering
  • Clinical Neurology

Background:

  • Deep brain stimulation (DBS) is a therapeutic intervention for Parkinson's disease.
  • Identifying and predicting motor side effects during DBS programming is crucial for patient safety and treatment efficacy.
  • Current methods for assessing tract activation during DBS may not be sensitive enough to detect subclinical changes.

Purpose of the Study:

  • To investigate motor evoked potentials (MEP) as a potential biomarker for corticobulbar (CBT) and corticospinal (CST) tract activation during DBS.
  • To correlate MEP thresholds with clinical motor side effect thresholds in Parkinson's disease patients undergoing DBS.

Main Methods:

  • 12 Parkinson's disease patients with subthalamic or pallidal DBS were included.
  • Contact mapping identified clinical motor side effect thresholds.
  • Electromyography (EMG) recorded MEPs from cranial and arm muscles under specific stimulation parameters.

Main Results:

  • MEP amplitudes increased with stimulation intensity, with shorter latencies in cranial muscles.
  • A significant correlation was found between clinical side effect and MEP thresholds (R²=0.31, p=0.0006).
  • MEP thresholds were often lower than side effect thresholds, suggesting subclinical tract activation, with an overall prediction accuracy of 0.72.

Conclusions:

  • MEP thresholds serve as a valuable, objective biomarker for detecting motor side effects during DBS programming.
  • The findings indicate that MEPs can reveal subclinical CBT/CST activations, improving the precision of DBS therapy.
  • This research highlights the potential of MEPs to optimize DBS parameter selection and enhance patient outcomes.