Nature Communications (May 2024)
Deep brain stimulation of symptom-specific networks in Parkinson’s disease
- Nanditha Rajamani,
- Helen Friedrich,
- Konstantin Butenko,
- Till Dembek,
- Florian Lange,
- Pavel Navrátil,
- Patricia Zvarova,
- Barbara Hollunder,
- Rob M. A. de Bie,
- Vincent J. J. Odekerken,
- Jens Volkmann,
- Xin Xu,
- Zhipei Ling,
- Chen Yao,
- Petra Ritter,
- Wolf-Julian Neumann,
- Georgios P. Skandalakis,
- Spyridon Komaitis,
- Aristotelis Kalyvas,
- Christos Koutsarnakis,
- George Stranjalis,
- Michael Barbe,
- Vanessa Milanese,
- Michael D. Fox,
- Andrea A. Kühn,
- Erik Middlebrooks,
- Ningfei Li,
- Martin Reich,
- Clemens Neudorfer,
- Andreas Horn
Affiliations
- Nanditha Rajamani
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin
- Helen Friedrich
- Center for Brain Circuit Therapeutics Department of Neurology Brigham & Women’s Hospital, Harvard Medical School
- Konstantin Butenko
- Center for Brain Circuit Therapeutics Department of Neurology Brigham & Women’s Hospital, Harvard Medical School
- Till Dembek
- Center for Brain Circuit Therapeutics Department of Neurology Brigham & Women’s Hospital, Harvard Medical School
- Florian Lange
- Department of Neurology, University Clinic of Würzburg
- Pavel Navrátil
- Department of Neurology, University Clinic of Würzburg
- Patricia Zvarova
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin
- Barbara Hollunder
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin
- Rob M. A. de Bie
- Department of Neurology, Amsterdam University Medical Center
- Vincent J. J. Odekerken
- Department of Neurology, Amsterdam University Medical Center
- Jens Volkmann
- Department of Neurology, University Clinic of Würzburg
- Xin Xu
- Department of Neurosurgery, Chinese PLA General Hospital
- Zhipei Ling
- Department of Neurosurgery, Hainan Hospital of Chinese PLA General Hospital
- Chen Yao
- Department of Neurosurgery, The National Key Clinic Specialty, Shenzhen Key Laboratory of Neurosurgery, the First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital
- Petra Ritter
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin
- Wolf-Julian Neumann
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin
- Georgios P. Skandalakis
- Section of Neurosurgery, Dartmouth Hitchcock Medical Center
- Spyridon Komaitis
- Department of Neurosurgery, National and Kapodistrian University of Athens Medical School, Evangelismos General Hospital
- Aristotelis Kalyvas
- Department of Neurosurgery, National and Kapodistrian University of Athens Medical School, Evangelismos General Hospital
- Christos Koutsarnakis
- Department of Neurosurgery, National and Kapodistrian University of Athens Medical School, Evangelismos General Hospital
- George Stranjalis
- Department of Neurosurgery, National and Kapodistrian University of Athens Medical School, Evangelismos General Hospital
- Michael Barbe
- Department of Neurology, University of Cologne
- Vanessa Milanese
- Neurosurgical Division, Hospital Beneficência Portuguesa de São Paulo
- Michael D. Fox
- Center for Brain Circuit Therapeutics Department of Neurology Brigham & Women’s Hospital, Harvard Medical School
- Andrea A. Kühn
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin
- Erik Middlebrooks
- Department of Radiology, Mayo Clinic Florida
- Ningfei Li
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin
- Martin Reich
- Department of Neurology, University Clinic of Würzburg
- Clemens Neudorfer
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin
- Andreas Horn
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin
- DOI
- https://doi.org/10.1038/s41467-024-48731-1
- Journal volume & issue
-
Vol. 15,
no. 1
pp. 1 – 16
Abstract
Abstract Deep Brain Stimulation can improve tremor, bradykinesia, rigidity, and axial symptoms in patients with Parkinson’s disease. Potentially, improving each symptom may require stimulation of different white matter tracts. Here, we study a large cohort of patients (N = 237 from five centers) to identify tracts associated with improvements in each of the four symptom domains. Tremor improvements were associated with stimulation of tracts connected to primary motor cortex and cerebellum. In contrast, axial symptoms are associated with stimulation of tracts connected to the supplementary motor cortex and brainstem. Bradykinesia and rigidity improvements are associated with the stimulation of tracts connected to the supplementary motor and premotor cortices, respectively. We introduce an algorithm that uses these symptom-response tracts to suggest optimal stimulation parameters for DBS based on individual patient’s symptom profiles. Application of the algorithm illustrates that our symptom-tract library may bear potential in personalizing stimulation treatment based on the symptoms that are most burdensome in an individual patient.
