Functional connectivity in Parkinson's disease candidates for deep brain stimulation

Area of Science:

• Neuroscience
• Medical Imaging
• Neurology

Background:

• Parkinson's disease (PD) is a progressive neurodegenerative disorder.
• Deep brain stimulation (DBS) is a therapeutic option for advanced PD.
• Identifying early indicators for DBS candidacy is crucial for timely intervention.

Purpose of the Study:

• To identify functional neuroimaging patterns that predict the clinical indication for DBS in PD patients.
• To explore the utility of resting-state functional MRI (RS-fMRI) in anticipating DBS eligibility.
• To differentiate neuroimaging characteristics between PD patients who become DBS candidates and those who do not.

Main Methods:

• Prospective cohort study of PD patients with annual neurological evaluations and RS-fMRI over 4 years.
• Graph analysis and connectomics were used to assess brain network properties and functional connectivity.
• Comparison of baseline and longitudinal RS-fMRI data between DBS-eligible patients, non-eligible patients, and healthy controls.

Main Results:

• At baseline, DBS candidates exhibited higher occipital network connectivity (nodal strength, local efficiency, clustering coefficient) compared to non-candidates and controls.
• Reduced functional connectivity between basal ganglia and sensorimotor/frontal networks was observed in DBS candidates at baseline.
• Longitudinal analysis revealed progressive decline in topological brain organization and posterior network connectivity in DBS candidates, alongside increased basal ganglia network connectivity.

Conclusions:

• RS-fMRI can identify distinct functional neuroimaging patterns associated with future DBS eligibility in PD.
• Baseline occipital hyperconnectivity and altered basal ganglia-sensorimotor/frontal connectivity may predict DBS candidacy.
• RS-fMRI shows potential for early prediction of DBS eligibility, supporting clinical decision-making in PD management.