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Subthalamic deep brain stimulation sweet spots and hyperdirect cortical connectivity in Parkinson’s disease

Akram, Harith; Sotiropoulos, Stamatios N.; Jbabdi, Saad; Georgiev, Dejan; Mahlknecht, Philipp; Hyam, Jonathan; Foltynie, Thomas; Limousin, Patricia; De Vita, Enrico; Jahanshahi, Marjan; Hariz, Marwan; Ashburner, John; Behrens, Timothy; Zrinzo, Ludvic

Authors

Harith Akram

Stamatios N. Sotiropoulos

Saad Jbabdi

Dejan Georgiev

Philipp Mahlknecht

Jonathan Hyam

Thomas Foltynie

Patricia Limousin

Enrico De Vita

Marjan Jahanshahi

Marwan Hariz

John Ashburner

Timothy Behrens

Ludvic Zrinzo

Abstract

Objectives
Firstly, to identify subthalamic region stimulation clusters that predict maximum improvement in rigidity, bradykinesia and tremor, or emergence of side-effects; and secondly, to map-out the cortical fingerprint, mediated by the hyperdirect pathways which predict maximum efficacy.
Methods
High angular resolution diffusion imaging in twenty patients with advanced Parkinson’s disease was acquired prior to bilateral subthalamic nucleus deep brain stimulation. All contacts were screened one-year from surgery for efficacy and side-effects at different amplitudes. Voxel-based statistical analysis of volumes of tissue activated models was used to identify significant treatment clusters. Probabilistic tractography was employed to identify cortical connectivity patterns associated with treatment efficacy.
Results
All patients responded well to treatment (46% mean improvement off medication UPDRS-III [p

Journal Article Type Article
Publication Date Sep 1, 2017
Journal NeuroImage
Print ISSN 1053-8119
Electronic ISSN 1095-9572
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 158
DOI https://doi.org/10.1016/j.neuroimage.2017.07.012
Keywords Diffusion weighted imaging (DWI), connectivity, Parkinson’s disease (PD), subthalamic nucleus (STN), volume of tissue activated (VTA), hyperdirect pathway
Publisher URL http://www.sciencedirect.com/science/article/pii/S1053811917305803
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by-nc-nd/4.0
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