{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T06:26:15Z","timestamp":1781504775544,"version":"3.54.1"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurosci."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Subthalamic nucleus deep brain stimulation (STN-DBS) is a standard-of-care (SoC) treatment for the motor symptoms of Parkinson\u2019s disease (PD); however, how therapeutic DBS influences motor output is incompletely understood. Specifically, the extent of electromyographic (EMG) modulation during DBS at therapeutic (or SoC) amplitude and its relationship to activity state could be better characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We studied the effects of DBS on muscle activity in sixteen participants receiving STN-DBS (in 17 stimulated hemispheres) by recording EMG activity in bilateral biceps, triceps, flexor carpi radialis, and extensor digitorum communis muscles. Data was acquired in the resting state and while participants alternated between isometric contraction and brief relaxation. We recorded EMG activity during low-frequency stimulation at participant-specific therapeutic amplitude and during stimulation using pulse amplitudes slightly above (125%) and below (75%) this level. Stimulus-locked responses from each condition were evaluated for the presence of a myogenic evoked potential.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>DBS at therapeutic amplitude elicited a myogenic response almost exclusively in the contralateral upper extremity (CUE), with at least one response occurring in 16 out of 17 hemispheres. Myogenic responses, which typically started between 10-30 milliseconds and often lasted until ~70-150 milliseconds post-stimulation, were more common in biceps\/triceps. Responses were more prevalent during active contraction compared to relax\/rest states as stimulation amplitude increased.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>These findings support that STN-DBS-induced myogenic activity is commonplace at therapeutic stimulation amplitudes used clinically; thus, studies evaluating the degree to which myogenic effects during SoC STN DBS are associated with the clinical and side effects of STN DBS therapy are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnins.2026.1733633","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T06:42:35Z","timestamp":1769668955000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of the myogenic effects of subthalamic nucleus deep brain stimulation at near therapeutic amplitudes"],"prefix":"10.3389","volume":"20","author":[{"given":"Carmen","family":"Toth","sequence":"first","affiliation":[{"name":"Department of Neurosciences, Lerner Research Institute, Cleveland Clinic","place":["Cleveland, OH, United States"]},{"name":"Case Western Reserve University School of Medicine","place":["Cleveland, OH, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett A.","family":"Campbell","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Lerner Research Institute, Cleveland Clinic","place":["Cleveland, OH, United States"]},{"name":"Center for Neurological Restoration, Neurological Institute, Cleveland Clinic","place":["Cleveland, OH, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo Favi","family":"Bocca","sequence":"additional","affiliation":[{"name":"Center for Neurological Restoration, Neurological Institute, Cleveland Clinic","place":["Cleveland, OH, United States"]},{"name":"Department of Neurosurgery, Neurological Institute, Cleveland Clinic","place":["Cleveland, OH, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle","family":"Baker","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Lerner Research Institute, Cleveland Clinic","place":["Cleveland, OH, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"Hogue","sequence":"additional","affiliation":[{"name":"Center for Neurological Restoration, Neurological Institute, Cleveland Clinic","place":["Cleveland, OH, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakov","family":"Tiefenbach","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Lerner Research Institute, Cleveland Clinic","place":["Cleveland, OH, United States"]},{"name":"Department of Neurosurgery, Neurological Institute, Cleveland Clinic","place":["Cleveland, OH, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Negrey","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Lerner Research Institute, Cleveland Clinic","place":["Cleveland, OH, United States"]},{"name":"Center for Neurological Restoration, Neurological Institute, Cleveland Clinic","place":["Cleveland, OH, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Cunningham","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, MetroHealth Medical Center","place":["Cleveland, OH, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9 G.","family":"Machado","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Lerner Research Institute, Cleveland Clinic","place":["Cleveland, OH, United States"]},{"name":"Center for Neurological Restoration, Neurological Institute, Cleveland Clinic","place":["Cleveland, OH, United States"]},{"name":"Department of Neurosurgery, Neurological Institute, Cleveland Clinic","place":["Cleveland, OH, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth B.","family":"Baker","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Lerner Research Institute, Cleveland Clinic","place":["Cleveland, OH, United States"]},{"name":"Center for Neurological Restoration, Neurological Institute, Cleveland Clinic","place":["Cleveland, OH, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1919","DOI":"10.1093\/brain\/122.10.1919","article-title":"Neurophysiological effects of stimulation through electrodes in the human subthalamic nucleus","volume":"122","author":"Ashby","year":"1999","journal-title":"Brain"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1159\/000029593","article-title":"Immediate motor effects of stimulation through electrodes implanted in the human globus pallidus","volume":"70","author":"Ashby","year":"1998","journal-title":"Stereotact. 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Neural Eng."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"2512","DOI":"10.1016\/j.clinph.2006.08.005","article-title":"The silent period of the thenar muscles to contralateral and ipsilateral deep brain stimulation","volume":"117","author":"Compta","year":"2006","journal-title":"Clin. Neurophysiol."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1093\/brain\/awl336","article-title":"Motor responses of muscles supplied by cranial nerves to subthalamic nucleus deep brain stimuli","volume":"130","author":"Costa","year":"2007","journal-title":"Brain"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1056\/NEJMoa060281","article-title":"A randomized trial of deep-brain stimulation for Parkinson's disease","volume":"355","author":"Deuschl","year":"2006","journal-title":"N. Engl. J. 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Neurophysiol."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1159\/000539433","article-title":"Mapping of capsular side effects by using intraoperative motor-evoked potentials during asleep deep brain stimulation surgery of the subthalamic nucleus for Parkinson's disease","volume":"102","author":"Karazapryanov","year":"2024","journal-title":"Stereotact. Funct. Neurosurg."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1007\/s00221-003-1707-y","article-title":"Comparison of motor effects following subcortical electrical stimulation through electrodes in the globus pallidus internus and cortical transcranial magnetic stimulation","volume":"155","author":"K\u00fchn","year":"2004","journal-title":"Exp. Brain Res."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1017\/s0317167100020382","article-title":"Motor responses to sudden limb displacements in primates with specific CNS lesions and in human patients with motor system disorders","volume":"2","author":"Lee","year":"1975","journal-title":"Can. J. Neurol. Sci."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1174","DOI":"10.1002\/mds.27042","article-title":"Pyramidal tract activation due to subthalamic deep brain stimulation in Parkinson's disease","volume":"32","author":"Mahlknecht","year":"2017","journal-title":"Mov. Disord."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1016\/j.clinph.2003.10.033","article-title":"Electric field and stimulating influence generated by deep brain stimulation of the subthalamic nucleus","volume":"115","author":"McIntyre","year":"2004","journal-title":"Clin. Neurophysiol."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"888","DOI":"10.1111\/ner.13386","article-title":"Motor evoked potentials improve targeting in deep brain stimulation surgery","volume":"25","author":"Nikolov","year":"2022","journal-title":"Neuromodulation"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"156869","DOI":"10.1155\/2011\/156869","article-title":"FieldTrip: open source software for advanced analysis of MEG, EEG, and invasive electrophysiological data","volume":"2011","author":"Oostenveld","year":"2011","journal-title":"Comput. Intell. Neurosci."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1113\/jphysiol.1992.sp019048","article-title":"Corticospinal projections to upper limb motoneurones in humans","volume":"448","author":"Palmer","year":"1992","journal-title":"J. Physiol."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1089\/brain.2022.0068","article-title":"Comparison of anatomical pathway models with tractography estimates of the pallidothalamic, cerebellothalamic, and corticospinal tracts","volume":"13","author":"Petersen","year":"2023","journal-title":"Brain Connect."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1016\/s0079-6123(08)60625-1","article-title":"The pyramidal projection to motoneurones of some muscle groups of the baboon's forelimb","volume":"12","author":"Phillips","year":"1964","journal-title":"Prog. Brain Res."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1136\/jnnp.46.1.35","article-title":"The behaviour of the long-latency stretch reflex in patients with Parkinson's disease","volume":"46","author":"Rothwell","year":"1983","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1093\/ons\/opaa414","article-title":"Motor evoked potential recordings during segmented deep brain stimulation-a feasibility study","volume":"20","author":"Shils","year":"2021","journal-title":"Oper. Neurosurg."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"2111499","DOI":"10.1016\/j.clinph.2025.2111499","article-title":"Motor evoked potentials as a side effect biomarker for deep brain stimulation","volume":"183","author":"Testini","year":"2025","journal-title":"Clin. Neurophysiol."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"813","DOI":"10.1136\/jnnp.2007.117507","article-title":"Pyramidal tract side effects induced by deep brain stimulation of the subthalamic nucleus","volume":"79","author":"Tommasi","year":"2008","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1016\/j.expneurol.2010.08.007","article-title":"Dissociation of motor symptoms during deep brain stimulation of the subthalamic nucleus in the region of the internal capsule","volume":"228","author":"Xu","year":"2011","journal-title":"Exp. Neurol."},{"key":"ref30","doi-asserted-by":"publisher","first-page":"895","DOI":"10.1111\/j.1469-7793.1999.0895p.x","article-title":"Dissociation of the pathways mediating ipsilateral and contralateral motor-evoked potentials in human hand and arm muscles","volume":"518","author":"Ziemann","year":"1999","journal-title":"J. Physiol."}],"container-title":["Frontiers in Neuroscience"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnins.2026.1733633\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T09:30:57Z","timestamp":1771925457000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnins.2026.1733633\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,29]]},"references-count":30,"alternative-id":["10.3389\/fnins.2026.1733633"],"URL":"https:\/\/doi.org\/10.3389\/fnins.2026.1733633","relation":{},"ISSN":["1662-453X"],"issn-type":[{"value":"1662-453X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,29]]},"article-number":"1733633"}}