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

IF 4.8 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Neurology Pub Date : 2024-10-07 DOI:10.1007/s00415-024-12703-8

Mallory L Hacker, David A Isaacs, Nanditha Rajamani, Kian Pazira, Eli Abdou, Sheffield Sharp, Thomas L Davis, Peter Hedera, Fenna T Phibbs, David Charles, Andreas Horn

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引用次数: 0

Abstract

Background: Stimulation of a specific site in the dorsolateral subthalamic nucleus (STN) was recently associated with slower motor progression in Parkinson's Disease (PD), based on the deep brain stimulation (DBS) in early-stage PD pilot clinical trial. Here, subject-level visualizations are presented of this early-stage PD dataset to further describe the relationship between active contacts and motor progression. This study also evaluates whether stimulation of the sweet spot and connectivity model associated with slower motor progression is also associated with improvements in long-term motor outcomes in patients with advanced-stage PD.

Methods: Active contacts of the early-stage PD cohort (N = 14) were analyzed alongside the degree of two-year motor progression. Sweet spot and connectivity models derived from the early-stage PD cohort were then used to determine how well they can estimate the variance in long-term motor outcomes in an independent STN-DBS cohort of advanced-stage PD patients (N = 29).

Results: In early-stage PD, proximity of stimulation to the dorsolateral STN was associated with slower motor progression. In advanced-stage PD, stimulation proximity to the early PD connectivity model and sweet spot were associated with better long-term motor outcomes (R = 0.60, P < 0.001; R = 0.37, P = 0.046, respectively).

Conclusions: Results suggest stimulation of a specific site in the dorsolateral STN is associated with both slower motor progression and long-term motor improvements in PD.

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评估帕金森病各阶段的运动进展连接模型。

背景：根据深部脑刺激（DBS）在帕金森病（PD）早期试点临床试验的结果，刺激背外侧丘脑下核（STN）的特定部位最近与帕金森病（PD）运动进展减慢有关。在此，我们将对这一早期帕金森病数据集进行受试者级别的可视化分析，以进一步描述主动接触与运动进展之间的关系。本研究还评估了刺激甜点和连通性模型是否与运动进展减慢相关，是否也与晚期帕金森病患者长期运动效果的改善相关：方法：对早期帕金森氏症队列（N = 14）的活动触点与两年运动进展程度进行了分析。然后利用从早期帕金森氏症患者队列中得出的甜点模型和连通性模型来确定它们在估算独立的 STN-DBS 晚期帕金森氏症患者队列（N = 29）的长期运动结果差异方面的效果：结果：在早期帕金森病患者中，靠近背外侧 STN 的刺激与运动进展减慢有关。在晚期帕金森病患者中，刺激靠近早期帕金森病连通性模型和甜点与更好的长期运动效果相关（R = 0.60，P 结论：结果表明，刺激背外侧 STN 的特定部位与帕金森病的长期运动效果相关：结果表明，刺激背外侧 STN 的特定部位与运动进展减慢和帕金森病长期运动改善有关。

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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来源期刊

Journal of Neurology 医学-临床神经学

CiteScore

10.00

自引率

5.00%

发文量

558

审稿时长

1 months

期刊介绍： The Journal of Neurology is an international peer-reviewed journal which provides a source for publishing original communications and reviews on clinical neurology covering the whole field. In addition, Letters to the Editors serve as a forum for clinical cases and the exchange of ideas which highlight important new findings. A section on Neurological progress serves to summarise the major findings in certain fields of neurology. Commentaries on new developments in clinical neuroscience, which may be commissioned or submitted, are published as editorials. Every neurologist interested in the current diagnosis and treatment of neurological disorders needs access to the information contained in this valuable journal.