TY  - JOUR
AU  - Jergas, Hannah
AU  - Petry-Schmelzer, Jan Niklas
AU  - Hannemann, Jonathan H
AU  - Thies, Tabea
AU  - Strelow, Joshua N
AU  - Rubi-Fessen, Ilona
AU  - Quinting, Jana
AU  - Baldermann, Juan Carlos
AU  - Mücke, Doris
AU  - Fink, Gereon R
AU  - Visser-Vandewalle, Veerle
AU  - Dembek, Till A
AU  - Barbe, Michael T
TI  - One side effect: two networks? Lateral and posteromedial stimulation spreads induce dysarthria in subthalamic deep brain stimulation for Parkinson’s disease
JO  - Journal of neurology, neurosurgery, and psychiatry
VL  - 96
IS  - 3
SN  - 0022-3050
CY  - London
PB  - BMJ Publishing Group
M1  - FZJ-2024-05469
SP  - jnnp-2024-333434 -
PY  - 2025
N1  - Funding JPS was funded by the Cologne Clinician Scientist Program (CCSP)/Faculty of Medicine/University of Cologne. Funded by the German Research Foundation (DFG, FI 773/15-1).JHH was supported by the Koeln Fortune Program/Faculty of Medicine, University of Cologne.
AB  - AbstractBackground Stimulation-induced dysarthria (SID) is a troublesome and potentially therapy-limiting side effect of deep brain stimulation of the subthalamic nucleus (STN-DBS) in patients with Parkinson’s disease (PD). To date, the origin of SID, and especially whether there is an involvement of cerebellar pathways as well as the pyramidal tract, remains a matter of debate. Therefore, this study aims to shed light on structural networks associated with SID and to derive a data-driven model to predict SID in patients with PD and STN-DBS.Methods Randomised, double-blinded monopolar reviews determining SID thresholds were conducted in 25 patients with PD and STN-DBS. A fibre-based mapping approach, implementing the calculation of fibr-wise ORs for SID, was employed to identify the distributional pattern of SID in the STN’s vicinity. The ability of the data-driven model to classify stimulation volumes as ‘causing SID’ or ‘not causing SID’ was validated by calculating receiver operating characteristics (ROC) in an independent out-of-sample cohort comprising 14 patients with PD and STN-DBS.Results Local fibre-based stimulation maps showed an involvement of fibres running lateral and posteromedial to the STN in the pathogenesis of SID, independent of the investigated hemisphere. ROC analysis in the independent out-of-sample cohort resulted in a good fit of the data-driven model for both hemispheres (area under the curve (AUC)left=0.88, AUCright=0.88).Conclusions This study reveals an involvement of both, cerebello-thalamic fibres, as well as the pyramidal tract, in the pathogenesis of SID in STN-DBS. The results may impact future postoperative programming strategies to avoid SID in patients with PD and STN-DBS
LB  - PUB:(DE-HGF)16
DO  - DOI:10.1136/jnnp-2024-333434
UR  - https://juser.fz-juelich.de/record/1030860
ER  -