%0 Journal Article
%A Petry-Schmelzer, Jan Niklas
%A Krause, Max
%A Dembek, Till A
%A Horn, Andreas
%A Evans, Julian
%A Ashkan, Keyoumars
%A Rizos, Alexandra
%A Silverdale, Monty
%A Schumacher, Wibke
%A Sack, Carolin
%A Loehrer, Philipp A
%A Fink, Gereon R
%A Fonoff, Erich T
%A Martinez-Martin, Pablo
%A Antonini, Angelo
%A Barbe, Michael T
%A Visser-Vandewalle, Veerle
%A Ray-Chaudhuri, K.
%A Timmermann, Lars
%A Dafsari, Haidar S
%T Non-motor outcomes depend on location of neurostimulation in Parkinson’s disease
%J Brain
%V 142
%N 11
%@ 1460-2156
%C Oxford
%I Oxford Univ. Press
%M FZJ-2019-04879
%P 3592-3604
%D 2019
%X Deep brain stimulation of the subthalamic nucleus is an effective and established therapy for patients with advanced Parkinson’s disease improving quality of life, motor symptoms and non-motor symptoms. However, there is a considerable degree of interindividual variability for these outcomes, likely due to variability in electrode placement and stimulation settings. Here, we present probabilistic mapping data from a prospective, open-label, multicentre, international study to investigate the influence of the location of subthalamic nucleus deep brain stimulation on non-motor symptoms in patients with Parkinson’s disease. A total of 91 Parkinson’s disease patients undergoing bilateral deep brain stimulation of the subthalamic nucleus were included, and we investigated NMSScale, NMSQuestionnaire, Scales for Outcomes in Parkinson’s disease-motor examination, -activities of daily living, and -motor complications, and Parkinson’s disease Questionnaire-8 preoperatively and at 6-month follow-up after surgery. Leads were localized in standard space using the Lead-DBS toolbox and individual volumes of tissue activated were calculated based on clinical stimulation settings. Probabilistic stimulation maps and non-parametric permutation statistics were applied to identify voxels with significant above or below average improvement for each scale and analysed using the DISTAL atlas. All outcomes improved significantly at follow-up. Significant spatial distribution patterns of neurostimulation were observed for NMSScale total score and its mood/apathy and attention/memory domains. For both domains, voxels associated with below average improvement were mainly located dorsal to the subthalamic nucleus. In contrast, above average improvement for mood/apathy was observed in the ventral border region of the subthalamic nucleus and in its sensorimotor subregion and for attention/memory in the associative subregion. A trend was observed for NMSScale sleep domain showing voxels with above average improvement located ventral to the subthalamic nucleus. Our study provides evidence that the interindividual variability of mood/apathy, attention/memory, and sleep outcomes after subthalamic nucleus deep brain stimulation depends on the location of neurostimulation. This study highlights the importance of holistic assessments of motor and non-motor aspects of Parkinson’s disease to tailor surgical targeting and stimulation parameter settings to patients’ personal profiles.
%F PUB:(DE-HGF)16
%9 Journal Article
%$ pmid:31553039
%U <Go to ISI:>//WOS:000504323200034
%R 10.1093/brain/awz285
%U https://juser.fz-juelich.de/record/865394