Symptom-specific differential motor network modulation by deep brain stimulation in Parkinson's disease

Area of Science:

• Neurosurgery
• Neurology
• Medical Imaging

Background:

• Deep brain stimulation (DBS) of the subthalamic nucleus (STN) effectively treats Parkinson's disease (PD) motor symptoms.
• Adverse effects and suboptimal outcomes can limit DBS efficacy, lacking objective monitoring metrics for neural changes.
• Intraoperative functional MRI (fMRI) offers a potential tool to observe brain activity during DBS.

Purpose of the Study:

• To investigate if intraoperative fMRI can predict therapeutic and adverse effects of STN DBS in PD patients.
• To correlate blood oxygen level-dependent (BOLD) signals with clinical outcomes and side effects of DBS.

Main Methods:

• Combined intraoperative fMRI with STN DBS in 20 PD patients.
• Analyzed BOLD signal changes in motor regions during DBS.
• Correlated fMRI activation patterns with improvements in tremor, rigidity, bradykinesia, and occurrence of adverse effects.

Main Results:

• DBS induced BOLD activation in motor regions (thalamus, cerebellum, motor cortex, basal ganglia).
• Improvements in tremor, rigidity, and bradykinesia correlated with activation in specific brain regions.
• Adverse effects like paresthesia, nausea, and muscle contractions correlated with activation in sensorimotor and striatal areas.

Conclusions:

• fMRI-detected DBS-induced activation patterns predict therapeutic efficacy and adverse effects.
• Combining fMRI with DBS shows translational potential for optimizing clinical stimulator settings in PD patients.