Journal
MOVEMENT DISORDERS
Volume 36, Issue 3, Pages 662-671Publisher
WILEY
DOI: 10.1002/mds.28376
Keywords
DBS; Parkinson' s disease; functional connectivity
Categories
Funding
- National Institutes of Health [R01 NS41509, NS41248, NS58797, NS075321, NS103957, NS107281, NS092865, NS097437, NS097799, NS075527, NS109487, 1U10NS077384, U54NS116025, U19NS110456, F31 NS071639, CO6 RR020092, R01 AG050263, T32 EB021955, P30NS98577]
- CTSA at Washington University [UL1TR000448]
- Brain & Behavior Research Foundation (NARSAD) Young Investigator Award
- American Parkinson Disease Association (APDA) Advanced Research Center for PD at WUSTL
- Greater St. Louis Chapter of the APDA
- Barnes Jewish Hospital Foundation (Clinical Translational Research Award)
- Barnes Jewish Hospital Foundation (Elliot Stein Family Fund)
- Barnes Jewish Hospital Foundation (PD Research Fund)
- Paula C and Rodger O. Riney Fund
- Jo Oertli Fund
- Scott G. Lentin Fund
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Resting-state functional connectivity MRI may predict motor response to subthalamic nucleus deep brain stimulation, with stronger connectivity between the left subthalamic nucleus and ipsilateral internal globus pallidus correlating with greater improvement in postsurgical motor outcomes. The integrity of pallidal-subthalamic nucleus circuits may be critical to motor benefits from deep brain stimulation.
Background Deep brain stimulation of the subthalamic nucleus is a widely used adjunctive therapy for motor symptoms of Parkinson's disease, but with variable motor response. Predicting motor response remains difficult, and novel approaches may improve surgical outcomes as well as the understanding of pathophysiological mechanisms. The objective of this study was to determine whether preoperative resting-state functional connectivity MRI predicts motor response from deep brain stimulation of the subthalamic nucleus. Methods We collected preoperative resting-state functional MRI from 70 participants undergoing subthalamic nucleus deep brain stimulation. For this cohort, we analyzed the strength of STN functional connectivity with seeds determined by stimulation-induced (ON/OFF) O-15 H2O PET regional cerebral blood flow differences in a partially overlapping group (n = 42). We correlated STN-seed functional connectivity strength with postoperative motor outcomes and applied linear regression to predict motor outcomes. Results Preoperative functional connectivity between the left subthalamic nucleus and the ipsilateral internal globus pallidus correlated with postsurgical motor outcomes (r = -0.39, P = 0.0007), with stronger preoperative functional connectivity relating to greater improvement. Left pallidal-subthalamic nucleus connectivity also predicted motor response to DBS after controlling for covariates. Discussion Preoperative pallidal-subthalamic nucleus resting-state functional connectivity predicts motor benefit from deep brain stimulation, although this should be validated prospectively before clinical application. These observations suggest that integrity of pallidal-subthalamic nucleus circuits may be critical to motor benefits from deep brain stimulation. (c) 2020 International Parkinson and Movement Disorder Society
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