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Cited by 711Neurological disorders and treatmentsObsessive-Compulsive Spectrum DisordersTranscranial Magnetic Stimulation Studies

Connectivity Predicts deep brain stimulation outcome in P arkinson disease

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Horn, Andreas, Reich, Martin, Vorwerk, Johannes, Li, Ningfei, Wenzel, Gregor, Fang, Qianqian, Schmitz‐Hübsch, Tanja, Nickl, Robert +4 more·2017·Annals of Neurology
DOI 10.1002/ana.24974PMC PMC5880678
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Abstract

Objective: The benefit of deep brain stimulation (DBS) for Parkinson disease (PD) may depend on connectivity between the stimulation site and other brain regions, but which regions and whether connectivity can predict outcome in patients remain unknown. Here, we identify the structural and functional connectivity profile of effective DBS to the subthalamic nucleus (STN) and test its ability to predict outcome in an independent cohort. Methods: A training dataset of 51 PD patients with STN DBS was combined with publicly available human connectome data (diffusion tractography and resting state functional connectivity) to identify connections reliably associated with clinical improvement (motor score of the Unified Parkinson Disease Rating Scale [UPDRS]). This connectivity profile was then used to predict outcome in an independent cohort of 44 patients from a different center. Results: In the training dataset, connectivity between the DBS electrode and a distributed network of brain regions correlated with clinical response including structural connectivity to supplementary motor area and functional anticorrelation to primary motor cortex ( p < 0.001). This same connectivity profile predicted response in an independent patient cohort ( p < 0.01). Structural and functional connectivity were independent predictors of clinical improvement ( p < 0.001) and estimated response in individual patients with an average error of 15% UPDRS improvement. Results were similar using connectome data from normal subjects or a connectome age, sex, and disease matched to our DBS patients. Interpretation: Effective STN DBS for PD is associated with a specific connectivity profile that can predict clinical outcome across independent cohorts. This prediction does not require specialized imaging in PD patients themselves. Ann Neurol 2017;82:67–78

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  • In psychiatric surgery, advanced tractography facilitates combining brain connectomic analyses with neuromodulation interventions.

    “In psychiatric surgery, advanced tractography facilitates the combination between brain connectomic analyses and neuromodulation interventions (Davidson et al., 2020; Horn et al., 2017; Riva-Posse et al., 2018)”

    From Quantitative mapping of the brain’s structural connectivity using diffusion MRI tractography: A review (2022) · cites this paper as Horn et al., 2017

    The Abstract > Interpretation and Subjects and Methods > Connectivity Estimation (page numbers unavailable) describe combining diffusion tractography and functional connectome analyses with deep brain stimulation. But the study tests this approach in Parkinson disease, not psychiatric surgery; its references to psychiatric applications do not establish the claim in that setting. (LLM, conf=0.87)

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Authors
Horn, A., Reich, M., Vorwerk, J., Li, N., Wenzel, G., Fang, Q., Schmitz‐Hübsch, T., Nickl, R., Kupsch, A., Volkmann, J., Kühn, A. A., & Fox, M. D.
Affiliations
  • Beth Israel Deaconess Medical Center (US)
  • University of Würzburg (DE)
  • University of Utah (US)
  • Technische Universität Berlin (DE)
  • Charité – Universitätsmedizin Berlin (DE)
  • Northeastern University (US)
  • NeuroCure Cluster of Excellence (DE)
  • Otto-von-Guericke-Universität Magdeburg (DE)
Corresponding author
  • Horn, Andreas
  • Fox, Michael D.
ORCID
Venue
Annals of Neurology
Publisher
Wiley
Published
2017-07
Volume
82
Issue
1
Pages
67-78
ISSN
  • 0364-5134 (ISSN-L)
  • 1531-8249
DOI
10.1002/ana.24974
PMC
PMC5880678
OpenAlex
W2622109244
Cited by
711
References
2
Citations by year
2026: 88 · 2025: 92 · 2024: 67 · 2023: 83 · 2022: 103 · 2021: 98 · 2020: 72 · 2019: 54 · 2018: 42 · 2017: 12
FWCI
34.29
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 24 d)
Locations
  • Annals of Neurology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • Deutsche Forschungsgemeinschaft (KFO247)
  • National Institute of Neurological Disorders and Stroke (K23NS083741)
  • Dystonia Medical Research Foundation
  • National Institutes of Health (R01‐GM114365)
  • National Institute of Dental and Craniofacial Research
  • National Institute of Mental Health
Topics
  • Health Sciences › Medicine › Neurology › Neurological disorders and treatments
  • Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
  • Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
Keywords
deep brain stimulation, Parkinson's disease, subthalamic nucleus, structural connectivity, functional connectivity, outcome prediction, supplementary motor area, primary motor cortex, anticorrelation, human connectome, diffusion tractography, motor symptoms
MeSH terms
Aged, Female, Humans, Male, Middle Aged, Motor Cortex, Parkinson Disease, Case-Control Studies, Treatment Outcome, Subthalamic Nucleus, Deep Brain Stimulation, Connectome

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