Session Information
Date: Monday, June 5, 2017
Session Title: Surgical Therapy: Parkinson’s Disease
Session Time: 1:45pm-3:15pm
Location: Exhibit Hall C
Objective: To find the neuroanatomical origins of deep brain stimulation (DBS) induced effects using probabilistic mapping.
Background: While DBS of the subthalamic nucleus (STN) and the ventral intermediate nucleus of the thalamus (VIM) are well-established therapies for Parkinson’s disease (PD), open questions remain regarding the neuroanatomical origin of beneficial motor effects as well as of stimulation‑induced side‑effects.
Methods: We generated probabilistic maps from a DBS dataset consisting of monopolar reviews of 25 PD patients with a total of over 500 stimulation settings. Patients were implanted either in the STN or the VIM. The dataset contained information about symptom improvement as well as side‑effect occurrence under DBS. Electrode positions were determined and transformed into a common neuroanatomical space using MRI coregistration. Probabilistic maps were created for every symptom using a spherical volume of neural activation (VNA). A voxel‑wise statistical analysis was performed to find clusters of voxels with symptom suppression or side‑effect elicitation significantly higher than the average of the dataset. Clusters were then validated using a non‑parametric permutation algorithm.
Results: Distinct clusters were detected for the suppression of rigidity, bradykinesia and tremor but cluster locations varied depending on the examined symptom. Rigidity was best suppressed in the dorsal parts of the STN, while the cluster for bradykinesia improvement was located at the lateral border of the STN. Tremor improvement was associated with more posterodorsal stimulation of the zona incerta and the ventral intermediate nucleus of the thalamus. Some but not all observed DBS‑induced side‑effects also showed distinct clusters, which were often but not always in line with neuroanatomical hypotheses about side‑effect origins.
Conclusions: Our method of probabilistic mapping revealed distinct topographies for symptom suppression as well as for certain DBS side‑effects. Larger datasets from multiple centers will be needed to confirm these results.
To cite this abstract in AMA style:
T. Dembek, J. Roediger, V. Visser-Vandewalle, L. Timmermann, M. Barbe. Probabilistic mapping of deep brain stimulation in Parkinson’s disease. [abstract]. Mov Disord. 2017; 32 (suppl 2). https://www.mdsabstracts.org/abstract/probabilistic-mapping-of-deep-brain-stimulation-in-parkinsons-disease/. Accessed October 31, 2024.« Back to 2017 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/probabilistic-mapping-of-deep-brain-stimulation-in-parkinsons-disease/