Universität zu Köln

Dembek, Till A., Roediger, Jan, Horn, Andreas ORCID: 0000-0002-0695-6025, Reker, Paul, Oehrn, Carina, Dafsari, Haidar S., Li, Ningfei ORCID: 0000-0003-3315-3591, Kuehn, Andrea A., Fink, Gereon R. ORCID: 0000-0002-8230-1856, Visser-Vandewalle, Veerle, Barbe, Michael T. and Timmermann, Lars (2019). Probabilistic sweet spots predict motor outcome for deep brain stimulation in Parkinson disease. Ann. Neurol., 86 (4). S. 527 - 539. HOBOKEN: WILEY. ISSN 1531-8249

Full text not available from this repository.

Abstract

Objective To investigate whether functional sweet spots of deep brain stimulation (DBS) in the subthalamic nucleus (STN) can predict motor improvement in Parkinson disease (PD) patients. Methods Stimulation effects of 449 DBS settings in 21 PD patients were clinically and quantitatively assessed through standardized monopolar reviews and mapped into standard space. A sweet spot for best motor outcome was determined using voxelwise and nonparametric permutation statistics. Two independent cohorts were used to investigate whether stimulation overlap with the sweet spot could predict acute motor outcome (10 patients, 163 settings) and long-term overall Unified Parkinson's Disease Rating Scale Part III (UPDRS-III) improvement (63 patients). Results Significant clusters for suppression of rigidity and akinesia, as well as for overall motor improvement, resided around the dorsolateral border of the STN. Overlap of the volume of tissue activated with the sweet spot for overall motor improvement explained R-2 = 37% of the variance in acute motor improvement, more than triple what was explained by overlap with the STN (R-2 = 9%) and its sensorimotor subpart (R-2 = 10%). In the second independent cohort, sweet spot overlap explained R-2 = 20% of the variance in long-term UPDRS-III improvement, which was equivalent to the variance explained by overlap with the STN (R-2 = 21%) and sensorimotor STN (R-2 = 19%). Interpretation This study is the first to predict clinical improvement of parkinsonian motor symptoms across cohorts based on local DBS effects only. The new approach revealed a distinct sweet spot for STN DBS in PD. Stimulation overlap with the sweet spot can predict short- and long-term motor outcome and may be used to guide DBS programming. ANN NEUROL 2019;86:527-538

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Dembek, Till A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Roediger, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Horn, Andreas UNSPECIFIED orcid.org/0000-0002-0695-6025 UNSPECIFIED Reker, Paul UNSPECIFIED UNSPECIFIED UNSPECIFIED Oehrn, Carina UNSPECIFIED UNSPECIFIED UNSPECIFIED Dafsari, Haidar S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Li, Ningfei UNSPECIFIED orcid.org/0000-0003-3315-3591 UNSPECIFIED Kuehn, Andrea A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fink, Gereon R. UNSPECIFIED orcid.org/0000-0002-8230-1856 UNSPECIFIED Visser-Vandewalle, Veerle UNSPECIFIED UNSPECIFIED UNSPECIFIED Barbe, Michael T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Timmermann, Lars UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-133302
DOI:	10.1002/ana.25567
Journal or Publication Title:	Ann. Neurol.
Volume:	86
Number:	4
Page Range:	S. 527 - 539
Date:	2019
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1531-8249
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CAUDAL ZONA INCERTA; SUBTHALAMIC NUCLEUS; ELECTRIC-FIELD; ACTIVATION; MOVEMENT; DBS; CONNECTIVITY; LOCATION; SPEECH; TARGET Multiple languages Clinical Neurology; Neurosciences Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13330