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@ARTICLE{Jergas:1030860,
      author       = {Jergas, Hannah and Petry-Schmelzer, Jan Niklas and
                      Hannemann, Jonathan H and Thies, Tabea and Strelow, Joshua N
                      and Rubi-Fessen, Ilona and Quinting, Jana and Baldermann,
                      Juan Carlos and Mücke, Doris and Fink, Gereon R and
                      Visser-Vandewalle, Veerle and Dembek, Till A and Barbe,
                      Michael T},
      title        = {{O}ne side effect: two networks? {L}ateral and
                      posteromedial stimulation spreads induce dysarthria in
                      subthalamic deep brain stimulation for {P}arkinson’s
                      disease},
      journal      = {Journal of neurology, neurosurgery, and psychiatry},
      volume       = {96},
      number       = {3},
      issn         = {0022-3050},
      address      = {London},
      publisher    = {BMJ Publishing Group},
      reportid     = {FZJ-2024-05469},
      pages        = {jnnp-2024-333434 -},
      year         = {2025},
      note         = {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.},
      abstract     = {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},
      cin          = {INM-3},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-3-20090406},
      pnm          = {5251 - Multilevel Brain Organization and Variability
                      (POF4-525)},
      pid          = {G:(DE-HGF)POF4-5251},
      typ          = {PUB:(DE-HGF)16},
      doi          = {10.1136/jnnp-2024-333434},
      url          = {https://juser.fz-juelich.de/record/1030860},
}