Tractography patterns of subthalamic nucleus deep brain stimulation
Open accessAbstract
Deep brain stimulation therapy is an effective symptomatic treatment for Parkinson's disease, yet the precise mechanisms responsible for its therapeutic effects remain unclear. Although the targets of deep brain stimulation are grey matter structures, axonal modulation is known to play an important role in deep brain stimulation's therapeutic mechanism. Several white matter structures in proximity to the subthalamic nucleus have been implicated in the clinical benefits of deep brain stimulation for Parkinson's disease. We assessed the connectivity patterns that characterize clinically beneficial electrodes in Parkinson's disease patients, after deep brain stimulation of the subthalamic nucleus. We evaluated 22 patients with Parkinson's disease (11 females, age 57 ± 9.1 years, disease duration 13.3 ± 6.3 years) who received bilateral deep brain stimulation of the subthalamic nucleus at the National Institutes of Health. During an initial electrode screening session, one month after deep brain stimulation implantation, the clinical benefits of each contact were determined. The electrode was localized by coregistering preoperative magnetic resonance imaging and postoperative computer tomography images and the volume of tissue activated was estimated from stimulation voltage and impedance. Brain connectivity for the volume of tissue activated of deep brain stimulation contacts was assessed using probabilistic tractography with diffusion-tensor data. Areas most frequently connected to clinically effective contacts included the thalamus, substantia nigra, brainstem and superior frontal gyrus. A series of discriminant analyses demonstrated that the strength of connectivity to the superior frontal gyrus and the thalamus were positively associated with clinical effectiveness. The connectivity patterns observed in our study suggest that the modulation of white matter tracts directed to the superior frontal gyrus and the thalamus is associated with favourable clinical outcomes and may contribute to the therapeutic effects of deep brain stimulation. Our method can be further developed to reliably identify effective deep brain stimulation contacts and aid in the programming process.
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Preoperative tractography can guide deep brain stimulation (DBS) or MR-guided focused ultrasound (MRgFUS) planning, identify the structural connectivity of the volume of tissue activated, and help avoid pathways associated with motor, cognitive, or mood-related adverse effects.
“Preoperative tractography can guide deep brain stimulation (DBS) or MR-guided focused ultrasound (MRgFUS) planning, identify the structural connectivity of the volume of tissue activated, and help avoid pathways associated with motor, cognitive, or mood-related adverse effects (Pujol et al., 2017; Rajamani et al., 2024; Vanegas-Arroyave et al., 2016).”
From 40 Years of diffusion MRI in the brain: From history to emerging frontiers (2026) · cites this paper as Vanegas-Arroyave et al., 2016
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- Authors
- Vanegas-Arroyave, N., Lauro, P. M., Huang, L., Hallett, M., Horovitz, S. G., Zaghloul, K. A., & Lungu, C.
- Affiliations
- National Institutes of Health (US)
- Venue
- Brain
- Publisher
- Oxford University Press (OUP)
- Published
- 2016-02-26
- Volume
- 139
- Issue
- 4
- Pages
- 1200-1210
- ISSN
- 0006-8950 (ISSN-L)
- 1460-2156
- PMC
- PMC5006230
- OpenAlex
- W2283119078
- Cited by
- 137
- References
- 50
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 10 · 2023: 12 · 2022: 18 · 2021: 26 · 2020: 15 · 2019: 16 · 2018: 13 · 2017: 9 · 2016: 4
- FWCI
- 10.53
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Brain (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Columbia Academic Commons (Columbia University)
- Funders
- National Institutes of Health
- National Institute of Neurological Disorders and Stroke
- 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, subthalamic nucleus, Parkinson's disease, probabilistic tractography, white matter connectivity, superior frontal gyrus, thalamus, substantia nigra, brainstem, electrode selection, clinical outcome prediction, diffusion tensor imaging
- MeSH terms
- Aged, Electrodes, Implanted, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neural Pathways, Parkinson Disease, Subthalamic Nucleus, Deep Brain Stimulation, Diffusion Tensor Imaging
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