Deep brain stimulation of symptom-specific networks in Parkinson's disease
- PMID: 38821913
- PMCID: PMC11143329
- DOI: 10.1038/s41467-024-48731-1
Deep brain stimulation of symptom-specific networks in Parkinson's disease
Abstract
Deep Brain Stimulation can improve tremor, bradykinesia, rigidity, and axial symptoms in patients with Parkinson's disease. Potentially, improving each symptom may require stimulation of different white matter tracts. Here, we study a large cohort of patients (N = 237 from five centers) to identify tracts associated with improvements in each of the four symptom domains. Tremor improvements were associated with stimulation of tracts connected to primary motor cortex and cerebellum. In contrast, axial symptoms are associated with stimulation of tracts connected to the supplementary motor cortex and brainstem. Bradykinesia and rigidity improvements are associated with the stimulation of tracts connected to the supplementary motor and premotor cortices, respectively. We introduce an algorithm that uses these symptom-response tracts to suggest optimal stimulation parameters for DBS based on individual patient's symptom profiles. Application of the algorithm illustrates that our symptom-tract library may bear potential in personalizing stimulation treatment based on the symptoms that are most burdensome in an individual patient.
© 2024. The Author(s).
Conflict of interest statement
N.R., B.H. and A.H. serve as inventors on patent application by Charité – University Medicine Berlin that covers multitract fiberfiltering and the cleartune algorithm introduced in this work. The application has been submitted on July 21, 2023, with the patent office of Luxembourg (application #LU103178). A.H. reports lecture fees from Boston Scientific and is a consultant for FxNeuromodulation and Abbott unrelated to present work. W.J.N. received honoraria unrelated to present work from Medtronic that is a manufacturer of deep brain stimulation devices. E.M. declares the following funding sources and employment: Boston Scientific Corp: Advisory Board Member, Research Support, Varian Medical Systems: Clinical Trial Funding, Advisory Board Member, Speaker’s Bureau; Vigil Neuroscience, Inc: Clinical Trial Funding. A.A.K. reports personal fees from Medtronic and Boston Scientific. The remaining authors declare no competing interest.
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