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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},
}