Deep brain stimulation of the subthalamic nucleus for Parkinson’s disease: A network imaging marker of the treatment response

Research Square Pub Date : 2024-05-07 DOI:10.21203/rs.3.rs-4178280/v1

Prashin Unadkat, An Vo, Yilong Ma, Shichun Peng, Nha Nguyen, M. Niethammer, Chris C. Tang, V. Dhawan, Ritesh Ramdhani, Albert Fenoy, S. Caminiti, Daniela Perani, D. Eidelberg

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Abstract

Abstract Subthalamic nucleus deep brain stimulation (STN-DBS) alleviates motor symptoms of Parkinson’s disease (PD), thereby improving quality of life. However, quantitative brain markers to evaluate DBS responses and select suitable patients for surgery are lacking. Here, we used metabolic brain imaging to identify a reproducible STN-DBS network for which individual expression levels increased with stimulation in proportion to motor benefit. Of note, measurements of network expression from metabolic and BOLD imaging obtained preoperatively predicted motor outcomes determined after DBS surgery. Based on these findings, we computed network expression in 175 PD patients, with time from diagnosis ranging from 0 to 21 years, and used the resulting data to predict the outcome of a potential STN-DBS procedure. While minimal benefit was predicted for patients with early disease, the proportion of potential responders increased after 4 years. Clinically meaningful improvement with stimulation was predicted in 18.9 – 27.3% of patients depending on disease duration.

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眼下核深部脑刺激治疗帕金森病：治疗反应的网络成像标记

摘要眼下核深部脑刺激（STN-DBS）可减轻帕金森病（PD）的运动症状，从而改善生活质量。然而，目前还缺乏用于评估 DBS 反应和选择合适手术患者的定量脑标记物。在这里，我们利用代谢脑成像技术确定了一个可重复的 STN-DBS 网络，该网络的个体表达水平随刺激的增加而增加，与运动获益成正比。值得注意的是，术前通过代谢和 BOLD 成像获得的网络表达测量结果可预测 DBS 手术后的运动效果。基于这些发现，我们计算了175名帕金森病患者的网络表达，这些患者的确诊时间从0年到21年不等，我们利用这些数据预测了潜在STN-DBS手术的结果。虽然预测早期患者的获益极小，但4年后潜在应答者的比例有所增加。根据病程长短，预测18.9-27.3%的患者在接受刺激后可获得有临床意义的改善。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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