Non-motor outcomes depend on location of neurostimulation in Parkinson's disease
| Autor: | Wibke Schumacher, Philipp Alexander Loehrer, Alexandra Rizos, Erich Talamoni Fonoff, Michael T. Barbe, Max Krause, K. Ray-Chaudhuri, Till A. Dembek, Veerle Visser-Vandewalle, Pablo Martinez-Martin, Lars Timmermann, Andreas Horn, Carolin Sack, Angelo Antonini, Jan Niklas Petry-Schmelzer, Monty Silverdale, Julian Evans, Europar, Keyoumars Ashkan, Gereon R. Fink, Haidar S. Dafsari |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Deep brain stimulation Parkinson's disease medicine.medical_treatment Deep Brain Stimulation Apathy Individuality Stimulation computer.software_genre volume of activated tissue Physical medicine and rehabilitation volume of tissue activated Voxel Memory Subthalamic Nucleus Surveys and Questionnaires Activities of Daily Living medicine Humans Attention ddc:610 Prospective Studies Neurostimulation Aged Brain Mapping Movement Disorders business.industry Parkinson Disease Middle Aged medicine.disease non-motor symptoms deep brain stimulation subthalamic nucleus Subthalamic nucleus Affect Mood Treatment Outcome Quality of Life Female Neurology (clinical) medicine.symptom business computer Psychomotor Performance |
| Zdroj: | Brain 142(11), 3592-3604 (2019). doi:10.1093/brain/awz285 |
| ISSN: | 1460-2156 |
| Popis: | Deep brain stimulation of the subthalamic nucleus is an effective and established therapy for patients with advanced Parkinson’s disease improving quality of life, motor symptoms and non-motor symptoms. However, there is a considerable degree of interindividual variability for these outcomes, likely due to variability in electrode placement and stimulation settings. Here, we present probabilistic mapping data from a prospective, open-label, multicentre, international study to investigate the influence of the location of subthalamic nucleus deep brain stimulation on non-motor symptoms in patients with Parkinson’s disease. A total of 91 Parkinson’s disease patients undergoing bilateral deep brain stimulation of the subthalamic nucleus were included, and we investigated NMSScale, NMSQuestionnaire, Scales for Outcomes in Parkinson’s disease-motor examination, -activities of daily living, and -motor complications, and Parkinson’s disease Questionnaire-8 preoperatively and at 6-month follow-up after surgery. Leads were localized in standard space using the Lead-DBS toolbox and individual volumes of tissue activated were calculated based on clinical stimulation settings. Probabilistic stimulation maps and non-parametric permutation statistics were applied to identify voxels with significant above or below average improvement for each scale and analysed using the DISTAL atlas. All outcomes improved significantly at follow-up. Significant spatial distribution patterns of neurostimulation were observed for NMSScale total score and its mood/apathy and attention/memory domains. For both domains, voxels associated with below average improvement were mainly located dorsal to the subthalamic nucleus. In contrast, above average improvement for mood/apathy was observed in the ventral border region of the subthalamic nucleus and in its sensorimotor subregion and for attention/memory in the associative subregion. A trend was observed for NMSScale sleep domain showing voxels with above average improvement located ventral to the subthalamic nucleus. Our study provides evidence that the interindividual variability of mood/apathy, attention/memory, and sleep outcomes after subthalamic nucleus deep brain stimulation depends on the location of neurostimulation. This study highlights the importance of holistic assessments of motor and non-motor aspects of Parkinson’s disease to tailor surgical targeting and stimulation parameter settings to patients’ personal profiles. |
| Databáze: | OpenAIRE |
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