Mapping Motor Pathways in Parkinson's Disease Patients with Subthalamic Deep Brain Stimulator: A Diffusion MRI Tractography Study

doi:10.1007/s40120-022-00331-1

	Mapping Motor Pathways in Parkinson's Disease Patients with Subthalamic Deep Brain Stimulator: A Diffusion MRI Tractography Study
	Li, Yan 1; He, Naying 1; Zhang, Chencheng 2; Liu, Yu 1; Li, Jun3 ; Sun, Bomin 2; Lai, Yijie 2; Li, Hongyang 2; Wang, Chengyan 4; Haacke, Ewart Mark 1,5; Yan, Fuhua 1; Li, Dianyou 2
	2022-06
发表期刊	NEUROLOGY AND THERAPY
ISSN	2193-8253
EISSN	2193-6536
发表状态	已发表
DOI	10.1007/s40120-022-00331-1
摘要	["Plain Language Summary For some more seriously affected Parkinson's disease (PD) patients, drugs are no longer effective in treating their symptoms. An alternate treatment is to use deep brain stimulation (DBS), a commonly used neurosurgical therapy for PD patients. For those DBS treatments targeting the subthalamic nucleus (STN), the electrical stimulation used may impact nearby white matter tracts and alter the effectiveness of the DBS treatment. The nigrostriatal pathway (NSP), dentato-rubro-thalamic tract, and hyperdirect pathway are three white matter tracts near the STN. They are all relevant to motor symptoms in PD. This study examined whether imaging these tracts using magnetic resonance imaging (MRI) is safe and feasible in the presence of DBS leads. The relationships between the fiber-tracking characteristics and distance to the DBS leads were then evaluated. For this purpose, 31 PD patients with stimulation-on were scanned on a 1.5 T MRI scanner using a diffusion tensor imaging sequence. A total of 23 subjects underwent another scan using the same sequence with stimulation-off. No adverse events related to diffusion tensor imaging were found. Among the white matter tracts near the STN, the NSP was best delineated, followed by the dentato-rubro-thalamic tract and the hyperdirect pathway. The connection probability of the left NSP was significantly lower than that of the right side as were the subject's motor symptoms. The closer the distance between the NSP and the stimulation location, the better the DBS outcome. These findings indicate that imaging white matter tracts with DBS on is safe and useful in mapping DBS outcomes.","Introduction This study assessed the safety of postoperative diffusion tensor imaging (DTI) with on-state deep brain stimulation (DBS) and the feasibility of reconstruction of the white matter tracts in the vicinity of the stimulation site of the subthalamic nucleus (STN). The association between the impact of DBS on the nigrostriatal pathway (NSP) and the treatment effect on motor symptoms in Parkinson's disease (PD) was then evaluated. Methods Thirty-one PD patients implanted with STN-DBS (mean age: 66 years; 25 male) were scanned on a 1.5-T magnetic resonance imaging (MRI) scanner using the DTI sequence with DBS on. Twenty-three of them were scanned a second time with DBS off. The NSP, dentato-rubro-thalamic tract (DRTT), and hyperdirect pathway (HDP) were generated using both deterministic and probabilistic tractography methods. The DBS-on-state and off-state tractography results were validated and compared. Afterward, the relationships between the characteristics of the reconstructed white matter tracts and the clinical assessment of PD symptoms and the DBS effect were further examined. Results No adverse events related to DTI were identified in either the DBS-on-state or off-state. Overall, the NSP was best reconstructed, followed by the DRTT and HDP, using the probabilistic tractography method. The connection probability of the left NSP was significantly lower than that of the right side (p < 0.05), and a negative correlation (r = -0.39, p = 0.042) was identified between the preoperative symptom severity in the medication-on state and the connection probability of the left NSP in the DBS-on-state images. Furthermore, the distance from the estimated left-side volume of tissue activated (VTA) by STN-DBS to the ipsilateral NSP was significantly shorter in the DBS-responsive group compared to the DBS-non-responsive group (p = 0.046). Conclusions DTI scanning is safe and delineation of white matter pathway is feasible for PD patients implanted with the DBS device. Postoperative DTI is a useful technique to strengthen our current understanding of the therapeutic effect of DBS for PD and has the potential to refine target selection strategies for brain stimulation."]
关键词	Postoperative imaging Diffusion tensor imaging Parkinson's disease Deep brain stimulation Subthalamic nucleus White matter fiber tracts
URL	查看原文
收录类别	SCI ; SCIE
语种	英语
资助项目	National Natural Science Foundation of China[81971576,81801652]
WOS研究方向	Neurosciences & Neurology
WOS类目	Clinical Neurology
WOS记录号	WOS:000756663500001
出版者	SPRINGER LONDON LTD
引用统计
文献类型	期刊论文
条目标识符	https://kms.shanghaitech.edu.cn/handle/2MSLDSTB/159545
专题	信息科学与技术学院_PI研究组_张玉瑶组
通讯作者	Yan, Fuhua; Li, Dianyou
作者单位	1.Shanghai Jiao Tong Univ, Ruijin Hosp, Dept Radiol, Sch Med, 197,Ruijin 2nd Rd, Shanghai 200025, Peoples R China 2.Shanghai Jiao Tong Univ, Ruijin Hosp, Ctr Funct Neurosurg, Dept Neurosurg,Sch Med, 197,Ruijin 2nd Rd, Shanghai 200025, Peoples R China 3.ShanghaiTech Univ, Sch Informat Sci & Technol, Shanghai, Peoples R China 4.Fudan Univ, Human Phenome Inst, Shanghai, Peoples R China 5.Wayne State Univ, Dept Radiol, Detroit, MI USA
推荐引用方式 GB/T 7714	Li, Yan,He, Naying,Zhang, Chencheng,et al. Mapping Motor Pathways in Parkinson's Disease Patients with Subthalamic Deep Brain Stimulator: A Diffusion MRI Tractography Study[J]. NEUROLOGY AND THERAPY,2022.
APA	Li, Yan.,He, Naying.,Zhang, Chencheng.,Liu, Yu.,Li, Jun.,...&Li, Dianyou.(2022).Mapping Motor Pathways in Parkinson's Disease Patients with Subthalamic Deep Brain Stimulator: A Diffusion MRI Tractography Study.NEUROLOGY AND THERAPY.
MLA	Li, Yan,et al."Mapping Motor Pathways in Parkinson's Disease Patients with Subthalamic Deep Brain Stimulator: A Diffusion MRI Tractography Study".NEUROLOGY AND THERAPY (2022).