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Controlling Parkinson's Disease With Adaptive Deep Brain Stimulation
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7 T MRI Connectivity-Guided Reprogramming Improves Deep Brain Stimulation Motor Outcome in Parkinson's Disease.

Yarit Wiggerts1, Annabel van der Weide2, Rick Schuurman1

  • 1Department of Neurosurgery, Amsterdam University Medical Center, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands.

Movement Disorders Clinical Practice
|June 30, 2026
PubMed
Summary
This summary is machine-generated.

Connectivity-guided reprogramming of subthalamic nucleus deep brain stimulation (DBS) significantly improves motor function and reduces OFF time in Parkinson's disease patients. This approach enhances DBS effectiveness without adverse effects.

Keywords:
Parkinson's diseaseconnectivitydeep brain stimulationmagnetic resonance imagingsubthalamic nucleus

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Area of Science:

  • Neurology
  • Neurosurgery
  • Medical Imaging

Background:

  • Subthalamic nucleus deep brain stimulation (STN-DBS) is a standard Parkinson's disease (PD) treatment.
  • 7-Tesla (7T) MRI connectivity analysis can visualize the patient-specific STN motor subdivision.
  • Hypothesis: Reprogramming STN-DBS outside this subdivision improves motor outcomes without adverse effects.

Purpose of the Study:

  • To evaluate if connectivity-guided reprogramming enhances motor outcomes in PD patients undergoing STN-DBS.
  • To assess the impact of precise VTA targeting on motor function and OFF time.

Main Methods:

  • Utilized 7T MRI probabilistic tractography to define STN motor subdivisions.
  • Visualized volume of tissue activated (VTA) with clinical programming.
  • Reprogrammed patients whose VTA did not overlap with the STN motor subdivision.
  • Assessed motor outcomes using MDS-UPDRS III and MDS-UPDRS IV.

Main Results:

  • Nine out of twelve patients were reprogrammed.
  • MDS-UPDRS III scores significantly improved post-reprogramming (p=0.005).
  • Mean OFF time decreased from 5 hours to 2 hours post-reprogramming.
  • No stimulation-induced adverse effects were reported.

Conclusions:

  • 7T MRI connectivity-guided reprogramming of STN-DBS substantially improves motor outcomes in PD patients.
  • This method effectively reduces OFF time and enhances overall DBS effectiveness.
  • Connectivity-guided programming offers a safer and more effective approach to STN-DBS in Parkinson's disease.