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@ARTICLE{Dembek:864237,
author = {Dembek, Till A. and Roediger, Jan and Horn, Andreas and
Reker, Paul and Oehrn, Carina and Dafsari, Haidar S. and Li,
Ningfei and Kühn, Andrea A. and Fink, Gereon R. and
Visser‐Vandewalle, Veerle and Barbe, Michael T. and
Timmermann, Lars},
title = {{P}robabilistic {S}weetspots {P}redict {M}otor {O}utcome
for {DBS} in {P}arkinson's {D}isease},
journal = {Annals of neurology},
volume = {86},
number = {4},
issn = {1531-8249},
address = {Hoboken, NJ},
publisher = {Wiley-Blackwell},
reportid = {FZJ-2019-04071},
pages = {527-538},
year = {2019},
abstract = {ObjectiveTo investigate whether functional sweet spots of
deep brain stimulation (DBS) in the subthalamic nucleus
(STN) can predict motor improvement in Parkinson disease
(PD) patients.MethodsStimulation effects of 449 DBS settings
in 21 PD patients were clinically and quantitatively
assessed through standardized monopolar reviews and mapped
into standard space. A sweet spot for best motor outcome was
determined using voxelwise and nonparametric permutation
statistics. Two independent cohorts were used to investigate
whether stimulation overlap with the sweet spot could
predict acute motor outcome (10 patients, 163 settings) and
long‐term overall Unified Parkinson's Disease Rating Scale
Part III (UPDRS‐III) improvement (63
patients).ResultsSignificant clusters for suppression of
rigidity and akinesia, as well as for overall motor
improvement, resided around the dorsolateral border of the
STN. Overlap of the volume of tissue activated with the
sweet spot for overall motor improvement explained
$R2 = 37\%$ of the variance in acute motor improvement,
more than triple what was explained by overlap with the STN
$(R2 = 9\%)$ and its sensorimotor subpart
$(R2 = 10\%).$ In the second independent cohort, sweet
spot overlap explained $R2 = 20\%$ of the variance in
long‐term UPDRS‐III improvement, which was equivalent to
the variance explained by overlap with the STN
$(R2 = 21\%)$ and sensorimotor STN
$(R2 = 19\%).InterpretationThis$ study is the first to
predict clinical improvement of parkinsonian motor symptoms
across cohorts based on local DBS effects only. The new
approach revealed a distinct sweet spot for STN DBS in PD.
Stimulation overlap with the sweet spot can predict short‐
and long‐term motor outcome and may be used to guide DBS
programming. ANN NEUROL 2019;86:527–538},
cin = {INM-3},
ddc = {610},
cid = {I:(DE-Juel1)INM-3-20090406},
pnm = {572 - (Dys-)function and Plasticity (POF3-572)},
pid = {G:(DE-HGF)POF3-572},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:31376171},
UT = {WOS:000486000600008},
doi = {10.1002/ana.25567},
url = {https://juser.fz-juelich.de/record/864237},
}