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. 2024 May 18;10(1):104.
doi: 10.1038/s41531-024-00717-y.

Microstructure predicts non-motor outcomes following deep brain stimulation in Parkinson's disease

Philipp A Loehrer  1   2 , Miriam H A Bopp  3   4 , Haidar S Dafsari  5 , Sieglinde Seltenreich  6 , Susanne Knake  6   4   7 , Christopher Nimsky  3   4 , Lars Timmermann  6   4   7 , David J Pedrosa #  6   4 , Marcus Belke #  6   7
Affiliations

Microstructure predicts non-motor outcomes following deep brain stimulation in Parkinson's disease

Philipp A Loehrer et al. NPJ Parkinsons Dis. .

Abstract

Deep brain stimulation of the subthalamic nucleus (STN-DBS) effectively treats motor and non-motor symptoms in advanced Parkinson's disease (PD). As considerable interindividual variability of outcomes exists, neuroimaging-based biomarkers, including microstructural metrics, have been proposed to anticipate treatment response. In this prospective open-label study, we sought to detect microstructural properties of brain areas associated with short-term non-motor outcomes following STN-DBS. Thirty-seven PD patients underwent diffusion MRI and clinical assessments at preoperative baseline and 6-month follow-up. Whole brain voxel-wise analysis assessed associations between microstructural metrics and non-motor outcomes. Intact microstructure within specific areas, including the right insular cortex, right putamen, right cingulum, and bilateral corticospinal tract were associated with greater postoperative improvement of non-motor symptom burden. Furthermore, microstructural properties of distinct brain regions were associated with postoperative changes in sleep, attention/memory, urinary symptoms, and apathy. In conclusion, diffusion MRI could support preoperative patient counselling by identifying patients with above- or below-average non-motor responses.

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Conflict of interest statement

PAL was supported by the SUCCESS-Program of the Philipps-University of Marburg and the ‘Stiftung zur Förderung junger Neurowissenschaftler’. MBo is a scientific consultant for Brainlab. HSD was funded by the EU Joint Programme – Neurodegenerative Disease Research (JPND), the Prof. Klaus Thiemann Foundation in the German Society of Neurology, the Felgenhauer Foundation, the KoelnFortune program of the Medical Faculty of the University of Cologne and has received honoraria by Everpharma, Kyowa Kirin, Bial, Oruen, and Stadapharm. SS reports no financial disclosures. SK reports no financial disclosures. CN is a scientific consultant for Brainlab. LT received payments as a consultant for Medtronic Inc. and Boston Scientific and received honoraria as a speaker on symposia sponsored by Bial, Zambon Pharma, UCB Schwarz Pharma, Desitin Pharma, Medtronic, Boston Scientific, and Abbott. The institution of LT, not LT personally, received funding by the German Research Foundation, the German Ministry of Education and Research, and Deutsche Parkinson Vereinigung. DJP has received honoraria for speaking at symposia sponsored by Boston Scientific Corp, Medtronic, AbbVie Inc, Zambon and Esteve Pharmaceuticals GmbH. He has received honoraria as a consultant for Boston Scientific Corp and Bayer, and he has received a grant from Boston Scientific Corp for a project entitled “Sensor-based optimisation of Deep Brain Stimulation settings in Parkinson’s disease” (COMPARE-DBS). The institution of DJP, not DJP personally, has received funding from the German Research Foundation, the German Ministry of Education and Research, the International Parkinson Foundation, the Horizon 2020 programme of the EU Commission and the Pohl Foundation in Marburg. Finally, DJP has received travel grants to attend congresses from Esteve Pharmaceuticals GmbH and Boston Scientific Corp. MBe reports no financial disclosures.

Figures

Fig. 1
Fig. 1. Positive association between ODI and postoperative change in NMS.
Clusters with a positive association between PD patients’ ODI-values and postoperative change in NMSS-T (yellow), Domain 2 (sleep/fatigue, red), Domain 5 (attention/memory, green), and Domain 7 (urinary, blue), as revealed by the whole brain analysis. P values were corrected for multiple comparisons using a permutation-based approach.
Fig. 2
Fig. 2. Negative association between ODI and postoperative change in NMS.
Clusters with a negative association between PD patients’ ODI-values and postoperative change in NMSS-T (yellow), Domain 2 (sleep/fatigue, red), Domain 5 (attention/memory, green), and Domain 7 (urinary, blue), as revealed by the whole brain analysis. P values were corrected for multiple comparisons using a permutation-based approach.
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