Universität zu Köln

Irmen, Friederike ORCID: 0000-0001-5574-3790, Horn, Andreas ORCID: 0000-0002-0695-6025, Mosley, Philip ORCID: 0000-0003-1721-3419, Perry, Alistair ORCID: 0000-0002-0794-1538, Petry-Schmelzer, Jan Niklas ORCID: 0000-0003-0749-3840, Dafsari, Haidar S., Barbe, Michael, Visser-Vandewalle, Veerle, Schneider, Gerd-Helge, Li, Ningfei ORCID: 0000-0003-3315-3591, Kuebler, Dorothee, Wenzel, Gregor and Kuehn, Andrea A. (2020). Left Prefrontal Connectivity Links Subthalamic Stimulation with Depressive Symptoms. Ann. Neurol., 87 (6). S. 962 - 976. HOBOKEN: WILEY. ISSN 1531-8249

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Abstract

Objective Subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson's disease (PD) not only stimulates focal target structures but also affects distributed brain networks. The impact this network modulation has on non-motor DBS effects is not well-characterized. By focusing on the affective domain, we systematically investigate the impact of electrode placement and associated structural connectivity on changes in depressive symptoms following STN-DBS, which have been reported to improve, worsen, or remain unchanged. Methods Depressive symptoms before and after STN-DBS surgery were documented in 116 patients with PD from 3 DBS centers (Berlin, Queensland, and Cologne). Based on individual electrode reconstructions, the volumes of tissue activated (VTAs) were estimated and combined with normative connectome data to identify structural connections passing through VTAs. Berlin and Queensland cohorts formed a training and cross-validation dataset used to identify structural connectivity explaining change in depressive symptoms. The Cologne data served as the test-set for which depressive symptom change was predicted. Results Structural connectivity was linked to depressive symptom change under STN-DBS. An optimal connectivity map trained on the Berlin cohort could predict changes in depressive symptoms in Queensland patients and vice versa. Furthermore, the joint training-set map predicted changes in depressive symptoms in the independent test-set. Worsening of depressive symptoms was associated with left prefrontal connectivity. Interpretation Fibers connecting the electrode with left prefrontal areas were associated with worsening of depressive symptoms. Our results suggest that for the left STN-DBS lead, placement impacting fibers to left prefrontal areas should be avoided to maximize improvement of depressive symptoms. ANN NEUROL 2020

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Irmen, Friederike UNSPECIFIED orcid.org/0000-0001-5574-3790 UNSPECIFIED Horn, Andreas UNSPECIFIED orcid.org/0000-0002-0695-6025 UNSPECIFIED Mosley, Philip UNSPECIFIED orcid.org/0000-0003-1721-3419 UNSPECIFIED Perry, Alistair UNSPECIFIED orcid.org/0000-0002-0794-1538 UNSPECIFIED Petry-Schmelzer, Jan Niklas UNSPECIFIED orcid.org/0000-0003-0749-3840 UNSPECIFIED Dafsari, Haidar S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Barbe, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Visser-Vandewalle, Veerle UNSPECIFIED UNSPECIFIED UNSPECIFIED Schneider, Gerd-Helge UNSPECIFIED UNSPECIFIED UNSPECIFIED Li, Ningfei UNSPECIFIED orcid.org/0000-0003-3315-3591 UNSPECIFIED Kuebler, Dorothee UNSPECIFIED UNSPECIFIED UNSPECIFIED Wenzel, Gregor UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuehn, Andrea A. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-336177
DOI:	10.1002/ana.25734
Journal or Publication Title:	Ann. Neurol.
Volume:	87
Number:	6
Page Range:	S. 962 - 976
Date:	2020
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1531-8249
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DEEP BRAIN-STIMULATION; HIGH-FREQUENCY STIMULATION; DORSAL RAPHE NUCLEUS; PARKINSONS-DISEASE; NONMOTOR SYMPTOMS; CORTEX; NEUROSTIMULATION; MOTOR; INTEGRATION; DISORDER Multiple languages Clinical Neurology; Neurosciences Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/33617