Sofía Avila Pérez, Vincent Koppelmans, Kevin M Duff, Marit Fl Ruitenberg
{"title":"One-year practice effects predict long-term cognitive outcomes in Parkinson's disease.","authors":"Sofía Avila Pérez, Vincent Koppelmans, Kevin M Duff, Marit Fl Ruitenberg","doi":"10.1177/1877718X251339585","DOIUrl":"10.1177/1877718X251339585","url":null,"abstract":"<p><p><b>Background:</b> Predicting which individuals with Parkinson's disease (PD) will develop cognitive deficits is challenging, but important towards selecting those individuals at higher risk of progression for personalized early intervention and enriching samples for clinical trials of disease modifying agents. <b>Objective:</b> To examine whether practice effects on cognitive tests across one-year are predictive of eventual cognitive impairment (CI) and dementia (PDD) in individuals with PD. <b>Methods:</b> Individuals with PD (<i>n</i> = 549) from the PPMI database who were cognitively intact at baseline were included for analysis. The Montreal Cognitive Assessment (MoCA) was administered at baseline and during annual follow-up visits over at least five years to determine if participants remained intact (MoCA ≥ 26) or developed CI (MoCA ≤ 25) or dementia (MoCA ≤ 21). Participants also completed a neuropsychological battery at baseline and again after a one-year interval. Practice effects on the cognitive tests across one-year were quantified with standardized regression-based change scores using PPMI data from cognitively intact subjects without PD. <b>Results:</b> Based on MoCA scores, 39% of patients developed CI and 10% developed PDD during the study. Linear regressions revealed smaller practice effects across one year in people with PD than in controls. Within the PD group, Cox regression analyses showed that smaller practice effects on tests of various cognitive domains were associated with an increased risk for CI. For PDD, only practice effects on a measure of processing speed significantly predicted cognitive outcomes. <b>Conclusions:</b> These findings demonstrate that practice effects have prognostic value in long-term cognitive outcomes in PD. This has important implications for clinical care and research, as one-year practice effects could help identify individuals at risk for CI and PDD and enrich samples for future clinical trials. Limitations of the present study pertain to the classification of cognitive impairment on the basis of a screening instrument (i.e., the MoCA) without evidence of the absence/presence of functional impairment, and the clinical utility of the one-year interval.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"858-867"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Willanka M Kapelle, Annelien M Oosterbaan, Gaia Patane, Capucine Piat, Khaled E Ghoniem, Emanuele Camerucci, Pierpaolo Turcano, James H Bower, Rodolfo Savica
{"title":"Pregnancy and delivery in women with Parkinson's disease: A case series.","authors":"Willanka M Kapelle, Annelien M Oosterbaan, Gaia Patane, Capucine Piat, Khaled E Ghoniem, Emanuele Camerucci, Pierpaolo Turcano, James H Bower, Rodolfo Savica","doi":"10.1177/1877718X251316161","DOIUrl":"10.1177/1877718X251316161","url":null,"abstract":"<p><p>BackgroundParkinson's disease (PD) is a progressive degenerative disease affecting people at any age; however, it is generally more prevalent in older age groups. Younger individuals, especially women, are facing significant challenges that pertain to pregnancy. Unfortunately, the available information is limited and supported mostly by anecdotical experience.ObjectiveTo gain insight into the interaction between early-onset PD and pregnancy.MethodsWe report on a case series of women, diagnosed with PD, that underwent pregnancy to explore the disease catachrestic, natural history, and different challenges associated with these unique group of people.ResultsWe identified a total of 9 participants who met our inclusion criteria, who had gone through a total of 12 pregnancies after onset of PD motor symptoms. In 10 out of 12 pregnancies, participants did not use any PD medication; throughout 1 pregnancy, a participant used pramipexole and throughout 1 pregnancy, a participant used levodopa/carbidopa.ConclusionsOur study supports the importance of further multicentric studies on pregnant women with PD to prospectively collect data on complications, birth outcomes, lactation, and PD severity.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"913-918"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aleksandra A Szwedo, Ingvild Dalen, Rachael A Lawson, Alison J Yarnall, Kenn Freddy Pedersen, Angus D Macleod, Carl E Counsell, David Bäckström, Lars Forsgren, Marta Camacho, Caroline H Williams-Gray, Ole-Bjørn Tysnes, Guido Alves, Jodi Maple-Grødem
{"title":"Dementia risk prediction in early Parkinson's disease: Validation and genetic integration of the Montreal Parkinson risk of dementia scale (MoPaRDS).","authors":"Aleksandra A Szwedo, Ingvild Dalen, Rachael A Lawson, Alison J Yarnall, Kenn Freddy Pedersen, Angus D Macleod, Carl E Counsell, David Bäckström, Lars Forsgren, Marta Camacho, Caroline H Williams-Gray, Ole-Bjørn Tysnes, Guido Alves, Jodi Maple-Grødem","doi":"10.1177/1877718X251329857","DOIUrl":"10.1177/1877718X251329857","url":null,"abstract":"<p><p>BackgroundPrediction models for dementia in Parkinson disease (PD) are needed to better identify high-risk patients, but existing risk models often lack validation in early-stage PD, when prognosis is most challenging.ObjectiveThis study aims to validate the Montreal Parkinson Risk of Dementia Scale (MoPaRDS) in six population-based cohorts of newly diagnosed PD and to evaluate if incorporating genetic factors (<i>GBA1</i> and <i>APOE-ε4</i>) enhances its performance.MethodsWe calculated MoPaRDS scores for 1108 newly diagnosed PD patients, and MoPaRDS + <i>GBA1 </i>+ <i>APOE</i> for the 941 patients with complete genetic data. We assessed the scores' performance in predicting dementia diagnosed over 10 years using time-dependent receiver operating characteristic (ROC) curves.ResultsOf the 1108 patients (mean age 69.5 ± 10.0 years; 61.0% men), 350 (31.6%) developed dementia. The area under the time-dependent ROC curve (AUC) was 0.79 for MoPaRDS and 0.80 for MoPaRDS + <i>GBA1 </i>+ <i>APOE.</i> Subdividing patients based on their MoPaRDS scores revealed annual observed risks of PDD of 39.4% (n = 8; high risk-), 11.4% (n = 176; intermediate risk-), and 5.0% (n = 942; low risk-group). With the suggested cutoff of ≥4, MoPaRDS had a sensitivity of 21.7% and specificity of 94.9%. Including the genetic items improved the sensitivity to 36.4% while maintaining comparable performance for specificity (91.5%).ConclusionsMoPaRDS demonstrates high specificity but limited sensitivity in early PD, highlighting that a one-size-fits-all approach is inadequate for predicting dementia risk in PD across different disease stages. Integrating genetic items increases sensitivity and identifies more newly diagnosed patients at higher risk of dementia, and may be a useful approach to assist dementia risk assessment in early-stage PD.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"868-878"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thomas Ollivier, David Devos, Gregory Kuchcinski, Luc Defebvre, Vincent Huin, Eugenie Mutez
{"title":"Conservative iron chelation for VAC14: Two-year clinical-radiological follow-up.","authors":"Thomas Ollivier, David Devos, Gregory Kuchcinski, Luc Defebvre, Vincent Huin, Eugenie Mutez","doi":"10.1177/1877718X251331820","DOIUrl":"10.1177/1877718X251331820","url":null,"abstract":"<p><p>There is a distinct lack of consensus on the most effective treatments for neurodegeneration with brain iron accumulation. This is due to the rarity of the disease, its phenotypic variability, and the multiplicity of pathophysiological mechanisms. Our team has already proposed the use of conservative iron chelation in cases of neuroferritinopathy, with interesting results. However, no mention has yet been made of the treatment of parkinsonism-dystonia related to <i>VAC14</i> gene mutations. The case reported here illustrates clinical stability after 2 years of conservative iron chelation, with an improvement in radiological images.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"925-928"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Incidence of antiepileptic drug use in Parkinson's disease.","authors":"Santeri Tuominen, Miia Tiihonen, Anne Paakinaho, Marjaana Koponen, Valtteri Kaasinen, Sirpa Hartikainen, Anna-Maija Tolppanen","doi":"10.1177/1877718X251343079","DOIUrl":"10.1177/1877718X251343079","url":null,"abstract":"<p><p>BackgroundAntiepileptics are used to treat epilepsy but also, e.g., neuropathic pain, essential tremor and dystonia. It is not known whether they are more commonly used in persons with Parkinson's disease (PD).ObjectiveTo assess the incidence of antiepileptic use in a nationwide cohort of persons with PD before and after the diagnosis and compared the findings to a matched cohort without PD.MethodsThis register-based Finnish nationwide cohort included 18365 persons diagnosed with PD between 2001-2015. Incidence of antiepileptic initiations, from 10 years before until 10 years after the PD diagnosis, was compared to an age-, sex-, and region-matched cohort without PD.ResultsAntiepileptics were more commonly initiated for persons with PD (29.3% of PD cohort and 15.2% of comparison cohort). Gabapentinoids were the most commonly initiated antiepileptics in both cohorts. A similar pattern in initiation rates was observed for both gabapentinoids and other antiepileptics, with increased incidence in the PD cohort approximately three years before the diagnosis and a significant peak around the time of PD diagnosis (the initiation rate at the time of PD diagnosis 3/100 and 1/100 person-years, for the PD and comparison cohorts, respectively). Clonazepam initiations were more common in the PD cohort (26.7% of initiations vs. 5.8% in the comparison cohort).ConclusionsThe increase in antiepileptic initiation rates before the diagnosis of PD suggests that they might be used for prodromal motor or non-motor symptoms.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"780-788"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tina Liu, J Eric Ahlskog, James Bower, Orhun Kantarci, Rodolfo Savica
{"title":"Dopamine-responsive post-anoxic parkinsonism.","authors":"Tina Liu, J Eric Ahlskog, James Bower, Orhun Kantarci, Rodolfo Savica","doi":"10.1177/1877718X251335044","DOIUrl":"10.1177/1877718X251335044","url":null,"abstract":"<p><p>BackgroundParkinsonism following hypoxic ischemic damage of the basal ganglia is an uncommon phenomenon that has been infrequently reported. However, only a few cases have noted improvement of symptoms with dopaminergic therapy. We report the clinical and imaging features of five patients with post-anoxic parkinsonism responsive to dopamine supplementation.ObjectiveTo describe a retrospective case series of five cases of dopamine-responsive post-anoxic parkinsonism.MethodsWe identified all the cases using the Mayo Clinic Data Management System utilizing advanced data explorer search engine for any patients evaluated for post anoxic parkinsonism and its associated acronyms from 2000-2024. Clinical features, neuroimaging, medication trials, and responses were obtained from chart review of identified patients.ResultsFive patients met the inclusion criteria. All patients underwent anoxic events followed by development of parkinsonism. Patients exhibited parkinsonism described as combinations of bradykinesia, rigidity, tremor, and postural instability. All patients underwent evaluation by a neurologist, MRI imaging, and treatment by dopaminergic agents. Of the five patients, four received carbidopa/levodopa whereas one received a dopamine agonist. All patients were clinically followed for a median of approximately 4 years and showed improvement in parkinsonism.ConclusionsParkinsonism following a hypoxic ischemic insult is a rare occurrence but response to dopaminergic therapy in those cases is even more scarcely described. Our cases series provides important implications for treatment options for patients with post anoxic parkinsonism.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"919-924"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thi Thu Ha Nguyen, Agnès Fournier, Émeline Courtois, Fanny Artaud, Pascale Tubert-Bitter, Gianluca Severi, Pei-Chen Lee, Emmanuel Roze, Ismaïl Ahmed, Anne Cm Thiébaut, Alexis Elbaz
{"title":"Use of β-adrenoreceptor drugs and Parkinson's disease incidence in women from the French E3N cohort study.","authors":"Thi Thu Ha Nguyen, Agnès Fournier, Émeline Courtois, Fanny Artaud, Pascale Tubert-Bitter, Gianluca Severi, Pei-Chen Lee, Emmanuel Roze, Ismaïl Ahmed, Anne Cm Thiébaut, Alexis Elbaz","doi":"10.1177/1877718X251330993","DOIUrl":"10.1177/1877718X251330993","url":null,"abstract":"<p><p>BackgroundExperimental and observational studies suggest that β-adrenoreceptor drugs (β2-agonists/β-antagonists) are associated with Parkinson's disease (PD) risk. Previous epidemiological studies may be hampered by reverse causation/confounding.ObjectiveWe examined the association of β-adrenoreceptor drugs with PD incidence, while addressing reverse causation and confounding in the E3N cohort study (2004-2018) using a new-user design.MethodsIncident β2-agonists/β-antagonists users were identified through drug claims databases. Incident PD was ascertained using multiple sources and validated by experts. Drugs-PD associations were assessed using time-varying Cox proportional hazards models adjusted for multiple confounders. Main analyses used a 5y-exposure lag to address reverse causation; sensitivity analyses used a 2y-lag or no lag. We set up a nested case-control study to compare trajectories of β2-agonists/β-antagonists prescriptions before diagnosis using logistic mixed models.ResultsAnalyses for β2-agonists were based on 81,890 women; 15,169 started using β2-agonists and 579 developed PD. PD incidence was 36% lower (hazard ratio = 0.64, 95% confidence interval = 0.41-0.98; p-trend = 0.04 for the number of claims) in users of long-acting/ultra-long-acting β2-agonists (LABAs/ultra-LABAs) compared to never users. There was no significant association for β2-agonists overall and short-acting β2-agonists. Analyses for β-antagonists were based on 75,896 women; 13,081 started using β-antagonists and 552 developed PD. PD incidence was similar in ever and never users in analyses with a 5y-lag but was higher in ever than never users in analyses with 2y-lag or no lag.ConclusionsIncident use of LABAs/ultra-LABAs is associated with lower PD incidence in women. Conversely, the association between β-antagonists and PD in women is likely due to reverse causation.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"789-804"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giovanni Bellomo, Federico Paolini Paoletti, Lorenzo Gaetani, Andrea Toja, Yihua Ma, Carly M Farris, Luis Concha-Marambio, Lucilla Parnetti
{"title":"Association of αS-SAA kinetics with clinical scores in the clinical spectrum of Parkinson's disease.","authors":"Giovanni Bellomo, Federico Paolini Paoletti, Lorenzo Gaetani, Andrea Toja, Yihua Ma, Carly M Farris, Luis Concha-Marambio, Lucilla Parnetti","doi":"10.1177/1877718X251342445","DOIUrl":"10.1177/1877718X251342445","url":null,"abstract":"<p><p>BackgroundCerebrospinal fluid (CSF) α-synuclein seed amplification assay (αS-SAA) is a recognized biomarker of synucleinopathy. In Parkinson's disease (PD), its potential for predicting clinical outcome needs to be further assessed.ObjectiveTo evaluate the associations between clinical outcome and αS-SAA kinetic parameters in a retrospective cohort of PD patients, also investigating whether CSF total protein content influences such associations.MethodsStudy cohort included cognitively unimpaired PD (PD-CN, n = 40), PD with mild cognitive impairment (PD-MCI, n = 44), and PD with dementia (PDD, n = 10) with available clinical assessment at baseline. Among them, n = 28 PD-CN and n = 31 PD-MCI patients had 2-year follow-up, and CSF biomarkers reflecting pathophysiological pathways other than synucleinopathy.ResultsIn PD-MCI, αS-SAA time-to-threshold (TTT) is associated with longitudinal changes in Mini-Mental State Examination. The association is stronger when accounting for CSF total protein concentration.ConclusionsαS-SAA TTT may represent a prognostic factor for cognitive decline in PD-MCI.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"759-765"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mortality and causes of death in patients with Parkinson's disease in Taiwan.","authors":"Shang-Jyh Chiou, Ya-Hui Hu, Yun-Chung Chen, Da-Ling Wang, Alexis Elbaz, Pei-Chen Lee","doi":"10.1177/1877718X251342490","DOIUrl":"10.1177/1877718X251342490","url":null,"abstract":"<p><p>BackgroundPrevious studies that examined Parkinson's disease (PD) mortality were mostly conducted in Western countries.ObjectsWe compared mortality rates and causes of death in PD patients and persons without PD from Taiwan over 15 years of follow-up.MethodsWithin the National Health Insurance database, we followed 50,290 incident PD patients (2003-2016) and 201,153 matched non-PD participants (controls) until 31/12/2018. We used multivariable Cox proportional-hazards regression models to compare mortality rates and causes of death in PD patients and controls. Due to non-proportionality, we performed stratification by follow-up duration (≤5/>5 years). We examined interactions between PD status participants' characteristics for all-cause mortality.ResultsPD patients had higher all-cause mortality than controls (HR = 1.40, 95% CI = 1.37-1.42); the association was stronger (<i>p</i> < 0.0001) after the first 5 years of follow-up (HR = 1.49 [1.46-1.53]) than before (HR = 1.34 [1.31-1.37]). The strongest associations were observed for suicide (HR = 1.79 [1.52-2.10]), dementia (HR = 1.69 [1.47-1.93]), and pneumonia (HR = 1.57 [1.49-1.65]). The association between PD and death decreased as age increased, and was stronger in patients without comorbidities, depression, and dementia than in those with.ConclusionsTaiwanese PD patients have reduced life expectancy throughout the course of disease with a stronger association after the first 5 years of follow-up. PD had a stronger impact on mortality in younger persons and in those without comorbidities. Prevention of pneumonia and suicide, and appropriate management of dementia and comorbidities would help reduce PD-related mortality. Our findings may help health authorities allocate resources to improve the management of PD patients in order to address PD-related mortality.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"819-828"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Predicting motor function improvement following deep brain stimulation of the subthalamic nucleus for Parkinson's disease based on STN-T2MRI radiomics.","authors":"Zhenke Li, Jinxing Sun, Haopeng Lin, Qianqian Wu, Junheng Jia, Xing Guo, Weiguo Li","doi":"10.1177/1877718X251319697","DOIUrl":"10.1177/1877718X251319697","url":null,"abstract":"<p><p>BackgroundMagnetic resonance imaging (MRI) findings for neural nuclei are an important reference for the diagnosis of Parkinson's disease (PD) and target localization in deep brain stimulation (DBS). The MRI characteristics of the subthalamic nucleus (STN) in PD patients are heterogeneous and may be indicative of differing levels of motor dysfunction in these individuals.ObjectiveTo investigate whether the radiological characteristics of the STN on preoperative T2-MRI can assist in predicting motor function improvement in PD patients following STN-DBS through radiomics.Methods137 patients with good improvement (Good) and 72 patients with poor improvement (Poor) were enrolled. T2-MRI images of the STN were used to extract radiomics features. Three machine learning models were used to classify the patients according to their radiomics features. Finally, the performance and clinical benefits of the models (radiomics model, clinical model, and clinical-radiomics model) were evaluated by calibration curve, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA).ResultsThe logistic regression and support vector machine models optimally distinguished Good and Poor, with areas under the curve (AUCs) of 0.844 and 0.853, respectively. The ROC curve, calibration curves, and DCA demonstrated that the integrated clinical-radiomics model had the highest clinical benefit among all models tested, in the test set (accuracy 0.876 and AUC 0.937).ConclusionsThe combined model incorporating the radiomics features of the STN and clinical features predicted motor function improvement following STN-DBS for PD well and may provide a noninvasive and effective approach for evaluating surgical indications.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"561-572"},"PeriodicalIF":4.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}