Deep brain stimulation (DBS) is an established therapeutic tool for the treatment of Parkinson's disease (PD). The mechanisms of DBS for PD are likely rooted in modulation of the subthalamo-pallidal network. However, it can be difficult to electrophysiologically interrogate that network in human patients. The recent identification of large amplitude evoked potential (EP) oscillations from DBS in the subthalamic nucleus (STN) or globus pallidus internus (GPi) are providing new scientific opportunities to expand understanding of human basal ganglia network activity. In turn, the goal of this review is to provide a summary of DBS-induced EPs in the basal ganglia and attempt to explain various components of the EP waveforms from their likely network origins. Our analyses suggest that DBS-induced antidromic activation of globus pallidus externus (GPe) is a key driver of these oscillatory EPs, independent of stimulation location (i.e. STN or GPi). This suggests a potentially more important role for GPe in the mechanisms of DBS for PD than typically assumed. And from a practical perspective, DBS EPs are poised to become clinically useful electrophysiological biomarker signals for verification of DBS target engagement.

中文翻译：

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剖析深部脑刺激引起基底神经节的神经活动

深部脑刺激（DBS）是治疗帕金森病（PD）的成熟治疗工具。 DBS 治疗 PD 的机制可能源于丘脑-苍白球网络的调节。然而，从电生理学角度研究人类患者的该网络可能很困难。最近对底丘脑核 (STN) 或苍白球内部 (GPi) 中 DBS 的大幅诱发电位 (EP) 振荡的识别，为扩大对人类基底神经节网络活动的理解提供了新的科学机会。反过来，本次综述的目的是提供基底神经节中 DBS 诱导的 EP 的总结，并尝试从其可能的网络起源解释 EP 波形的各个组成部分。我们的分析表明，DBS 诱导的外苍白球 (GPe) 逆向激活是这些振荡 EP 的关键驱动因素，与刺激位置（即 STN 或 GPi）无关。这表明 GPe 在 DBS 治疗 PD 的机制中可能发挥比通常假设更重要的作用。从实践的角度来看，DBS EP 有望成为临床上有用的电生理生物标志物信号，用于验证 DBS 目标参与。