Probabilistic sweet spots predict motor outcome for deep brain stimulation in Parkinson disease
Annals of Neurology Sep 21, 2019
Dembek TA, Roediger J, Horn A, et al. - Researchers assessed if motor improvement in Parkinson disease (PD) patients can be predicted by functional sweet spots of deep brain stimulation (DBS) in the subthalamic nucleus (STN). Via standardized monopolar reviews, a clinical and quantitative evaluation of stimulation influences of 449 DBS settings in 21 PD patients was performed and these were mapped into standard space. Voxelwise and nonparametric permutation statistics were used to ascertain a sweet spot for best motor outcome. This is the first inquiry to foretell clinical improvement of motor symptoms in PD across cohorts based on local DBS impacts only. The novel approach showed a distinct sweet spot for STN DBS in PD. The ability of stimulation overlap with the sweet spot in predicting short- and long-term motor outcome was highlighted. Furthermore, it may serve to guide DBS programming.
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