Functional network differences between unilateral and bilateral deep brain stimulation of the subthalamic nucleus

Abstract

Unilateral versus bilateral implantation is a critical surgical consideration for deep brain stimulation in Parkinson’s disease; however, the differing therapeutic effects remain incompletely understood. Using functional magnetic resonance imaging during active stimulation, we show that bilateral stimulation reinforces the recruitment of key motor hubs while reducing non-motor responses seen with unilateral stimulation and correlates with improved outcomes. This suggests a potential mechanistic basis for better motor function following bilateral stimulation.