@article{5a16004699bf4188a81e06beff055ced,
title = "Resting-State Functional Connectivity Predicts STN DBS Clinical Response",
abstract = "Background: Deep brain stimulation of the subthalamic nucleus is a widely used adjunctive therapy for motor symptoms of Parkinson's disease, but with variable motor response. Predicting motor response remains difficult, and novel approaches may improve surgical outcomes as well as the understanding of pathophysiological mechanisms. The objective of this study was to determine whether preoperative resting-state functional connectivity MRI predicts motor response from deep brain stimulation of the subthalamic nucleus. Methods: We collected preoperative resting-state functional MRI from 70 participants undergoing subthalamic nucleus deep brain stimulation. For this cohort, we analyzed the strength of STN functional connectivity with seeds determined by stimulation-induced (ON/OFF) 15O H2O PET regional cerebral blood flow differences in a partially overlapping group (n = 42). We correlated STN-seed functional connectivity strength with postoperative motor outcomes and applied linear regression to predict motor outcomes. Results: Preoperative functional connectivity between the left subthalamic nucleus and the ipsilateral internal globus pallidus correlated with postsurgical motor outcomes (r = −0.39, P = 0.0007), with stronger preoperative functional connectivity relating to greater improvement. Left pallidal-subthalamic nucleus connectivity also predicted motor response to DBS after controlling for covariates. Discussion: Preoperative pallidal-subthalamic nucleus resting-state functional connectivity predicts motor benefit from deep brain stimulation, although this should be validated prospectively before clinical application. These observations suggest that integrity of pallidal-subthalamic nucleus circuits may be critical to motor benefits from deep brain stimulation.",
keywords = "DBS, Parkinson's disease, functional connectivity",
author = "Younce, {John R.} and Campbell, {Meghan C.} and Tamara Hershey and Tanenbaum, {Aaron B.} and Mikhail Milchenko and Mwiza Ushe and Morvarid Karimi and Tabbal, {Samer D.} and Kim, {Albert E.} and Snyder, {Abraham Z.} and Perlmutter, {Joel S.} and Norris, {Scott A.}",
note = "Funding Information: M.C.C. — Washington University School of Medicine (employment); McDonnell Center for Systems Neuroscience at Wash U, Mallinckrodt Institute of Radiology at Wash U pilot project grant, Neuroimaging Laboratory at Wash U. Innovation pilot grant, Biomarkers Across Neurodegenerative Diseases program funded by the Alzheimer's Association and M.J. Fox Foundation, NIH R01 NS097437, R01 NS075321, R01 NS097799, R21 AG063974, R61 AT010753 (research support); Parkinson Foundation (honoraria). Funding Information: J.R.Y. — Washington University School of Medicine (employment); NIH T32 EB021955 (research support); International Parkinson and Movement Disorder Society (travel grant). Funding Information: J.S.P. — Washington University School of Medicine (employment); Michael J. Fox Foundation, Barnes‐Jewish Hospital Foundation — Elliot Stein Family Fund and Parkinson Disease Research Fund, American Parkinson Disease Association Advanced Research Center at Washington University, Greater St. Louis Chapter of the APDA, Paula and Rodger Riney Fund, Jo Oertli Fund, Huntington Disease Society of America, Murphy Fund, CHDI, Department of Defense DOD W81XWH‐217‐1‐0393, NIH NS075321, NS103957, NS107281, NS092865, U10NS077384, NS097437, U54NS116025, U19 NS110456, AG050263, AG‐64937, NS097799, NS075527, ES029524, NS109487, R61 AT010753 (research support); Dystonia Coalition — supported by NIH NS116025, NS065701, TR001456 (codirector); Dystonia Medical Research Foundation (Director of Medical and Scientific Advisory Committee); Parkinson Study Group (Chair of the Scientific Advisory Committee); Huntington Study Group (Chair of the Standards Committee and member of the Education Committee); American Parkinson Disease Association (Scientific Advisory Board); ENROLL‐HD (Chair of the Scientific and Publication Committee); CHDI, Huntington Disease Study Group, Parkinson Study Group, Beth Israel Hospital, U. Pennsylvania, Stanford U. (honoraria); Wood, Cooper and Peterson, LLC, and Simmons and Simmons LLP (medical‐legal consultation). Funding Information: S.A.Nv — Washington University School of Medicine (employment); Dystonia Medical Research Foundation, Scott G. Lentin Fund, NIH R01 NS103957, TR00145609 (research support). Funding Information: National Institutes of Health; R01 NS41509; NS41248; NS58797; NS075321, NS103957, NS107281, NS092865, NS097437, NS097799, NS075527; NS109487, 1U10NS077384, U54NS116025, U19NS110456; F31 NS071639; CO6 RR020092; R01 AG050263; T32 EB021955, P30NS98577, CTSA at Washington University (UL1TR000448); Brain & Behavior Research Foundation (NARSAD) Young Investigator Award; American Parkinson Disease Association (APDA) Advanced Research Center for PD at WUSTL; Greater St. Louis Chapter of the APDA; Barnes Jewish Hospital Foundation (Clinical Translational Research Award; Elliot Stein Family Fund; PD Research Fund); Paula C and Rodger O. Riney Fund, the Jo Oertli Fund, and the Scott G. Lentin Fund. Funding agencies: Funding Information: A.E.K. — Dana Farber Cancer Institute and Massachusetts General Hospital (employment); American Brain Tumor Association Basic Research Fellowship in honor of Paul Fabbri (research support). Publisher Copyright: {\textcopyright} 2020 International Parkinson and Movement Disorder Society",
year = "2021",
month = mar,
doi = "10.1002/mds.28376",
language = "English",
volume = "36",
pages = "662--671",
journal = "Movement Disorders",
issn = "0885-3185",
number = "3",
}