Evaluating a motor progression connectivity model across Parkinson's disease stages

Area of Science:

• Neuroscience
• Neurology
• Neurosurgery

Background:

• Deep brain stimulation (DBS) in early Parkinson's Disease (PD) showed potential for slowing motor progression via subthalamic nucleus (STN) stimulation.
• Subject-level visualizations are used to further describe the relationship between active DBS contacts and motor progression in early PD.
• This study investigates if the STN 'sweet spot' and connectivity model associated with slower progression also improve long-term outcomes in advanced PD.

Purpose of the Study:

• To visualize and describe the relationship between active DBS contacts and motor progression in early-stage PD.
• To evaluate if the STN sweet spot and connectivity model from early PD predict long-term motor outcomes in advanced PD.

Main Methods:

• Analyzed active contacts in an early-stage PD cohort (N=14) and their two-year motor progression.
• Applied sweet spot and connectivity models from the early cohort to an independent advanced-stage PD cohort (N=29).
• Assessed the models' ability to estimate variance in long-term motor outcomes in the advanced PD group.

Main Results:

• In early PD, stimulation proximity to the dorsolateral STN correlated with slower motor progression.
• In advanced PD, stimulation proximity to the early PD connectivity model predicted better long-term outcomes (R=0.60, P<0.001).
• Stimulation proximity to the early PD sweet spot also predicted better long-term outcomes in advanced PD (R=0.37, P=0.046).

Conclusions:

• Stimulation of a specific dorsolateral STN site is associated with slower motor progression in early Parkinson's Disease.
• This precise STN stimulation is also linked to improved long-term motor outcomes in advanced Parkinson's Disease.
• Findings support targeting specific STN sites for both slowing PD progression and enhancing long-term motor function.