Petry-Schmelzer, Jan Niklas, Krause, Max ORCID: 0000-0002-4355-165X, Dembek, Till A., Horn, Andreas ORCID: 0000-0002-0695-6025, Evans, Julian, Ashkan, Keyoumars, Rizos, Alexandra, Silverdale, Monty, Schumacher, Wibke, Sack, Carolin, Loehrer, Philipp A., Fink, Gereon R. ORCID: 0000-0002-8230-1856, Fonoff, Erich T., Martinez-Martin, Pablo, Antonini, Angelo ORCID: 0000-0003-1040-2807, Barbe, Michael T., Visser-Vandewalle, Veerle, Ray-Chaudhuri, K., Timmermann, Lars, Dafsari, Haidar S., Ray-Chaudhuri, Kallol, Antonini, Angelo ORCID: 0000-0003-1040-2807, Martinez-Martin, Pablo, Odin, Per, Schrag, Anette ORCID: 0000-0002-9872-6680, Weintraub, Daniel ORCID: 0000-0003-0633-7168, Barone, Paolo, Brooks, David J., Brown, Richard G., Jenner, Peter, Jeon, B., Lyons, Kelly, Pavese, Nicola, Politis, Marios, Postuma, Ronald B., Schapira, Anthony ORCID: 0000-0002-3018-3966, Stocchi, Fabrizio, Timmermann, Lars, Tsuboi, Yoshio, Rizos, Alexandra and Sauerbier, Anna (2019). Non-motor outcomes depend on location of neurostimulation in Parkinson's disease. Brain, 142. S. 3592 - 3605. OXFORD: OXFORD UNIV PRESS. ISSN 1460-2156

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Abstract

Deep brain stimulation of the subthalamic nucleus is an effective and established therapy for patients with advanced Parkinson's disease improving quality of life, motor symptoms and non-motor symptoms. However, there is a considerable degree of interindividual variability for these outcomes, likely due to variability in electrode placement and stimulation settings. Here, we present probabilistic mapping data from a prospective, open-label, multicentre, international study to investigate the influence of the location of subthalamic nucleus deep brain stimulation on non-motor symptoms in patients with Parkinson's disease. A total of 91 Parkinson's disease patients undergoing bilateral deep brain stimulation of the subthalamic nucleus were included, and we investigated NMSScale, NMSQuestionnaire, Scales for Outcomes in Parkinson's disease-motor examination, -activities of daily living, and -motor complications, and Parkinson's disease Questionnaire-8 preoperatively and at 6-month follow-up after surgery. Leads were localized in standard space using the Lead-DBS toolbox and individual volumes of tissue activated were calculated based on clinical stimulation settings. Probabilistic stimulation maps and non-parametric permutation statistics were applied to identify voxels with significant above or below average improvement for each scale and analysed using the DISTAL atlas. All outcomes improved significantly at follow-up. Significant spatial distribution patterns of neurostimulation were observed for NMSScale total score and its mood/apathy and attention/ memory domains. For both domains, voxels associated with below average improvement were mainly located dorsal to the subthalamic nucleus. In contrast, above average improvement for mood/apathy was observed in the ventral border region of the subthalamic nucleus and in its sensorimotor subregion and for attention/memory in the associative subregion. A trend was observed for NMSScale sleep domain showing voxels with above average improvement located ventral to the subthalamic nucleus. Our study provides evidence that the interindividual variability of mood/apathy, attention/memory, and sleep outcomes after subthalamic nucleus deep brain stimulation depends on the location of neurostimulation. This study highlights the importance of holistic assessments of motor and non-motor aspects of Parkinson's disease to tailor surgical targeting and stimulation parameter settings to patients' personal profiles.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Petry-Schmelzer, Jan NiklasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Krause, MaxUNSPECIFIEDorcid.org/0000-0002-4355-165XUNSPECIFIED
Dembek, Till A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Horn, AndreasUNSPECIFIEDorcid.org/0000-0002-0695-6025UNSPECIFIED
Evans, JulianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ashkan, KeyoumarsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rizos, AlexandraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Silverdale, MontyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schumacher, WibkeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sack, CarolinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Loehrer, Philipp A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fink, Gereon R.UNSPECIFIEDorcid.org/0000-0002-8230-1856UNSPECIFIED
Fonoff, Erich T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Martinez-Martin, PabloUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Antonini, AngeloUNSPECIFIEDorcid.org/0000-0003-1040-2807UNSPECIFIED
Barbe, Michael T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Visser-Vandewalle, VeerleUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ray-Chaudhuri, K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Timmermann, LarsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dafsari, Haidar S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ray-Chaudhuri, KallolUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Antonini, AngeloUNSPECIFIEDorcid.org/0000-0003-1040-2807UNSPECIFIED
Martinez-Martin, PabloUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Odin, PerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schrag, AnetteUNSPECIFIEDorcid.org/0000-0002-9872-6680UNSPECIFIED
Weintraub, DanielUNSPECIFIEDorcid.org/0000-0003-0633-7168UNSPECIFIED
Barone, PaoloUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Brooks, David J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Brown, Richard G.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jenner, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jeon, B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lyons, KellyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pavese, NicolaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Politis, MariosUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Postuma, Ronald B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schapira, AnthonyUNSPECIFIEDorcid.org/0000-0002-3018-3966UNSPECIFIED
Stocchi, FabrizioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Timmermann, LarsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tsuboi, YoshioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rizos, AlexandraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sauerbier, AnnaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-128664
DOI: 10.1093/brain/awz285
Journal or Publication Title: Brain
Volume: 142
Page Range: S. 3592 - 3605
Date: 2019
Publisher: OXFORD UNIV PRESS
Place of Publication: OXFORD
ISSN: 1460-2156
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
DEEP-BRAIN-STIMULATION; QUALITY-OF-LIFE; SUBTHALAMIC NUCLEUS; MOTOR IMPAIRMENTS; FOLLOW-UP; SYMPTOMS; DEPRESSION; SCALE; CONNECTIVITY; ACTIVATIONMultiple languages
Clinical Neurology; NeurosciencesMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/12866

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