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000865394 1001_ $$0P:(DE-HGF)0$$aPetry-Schmelzer, Jan Niklas$$b0$$eCorresponding author
000865394 245__ $$aNon-motor outcomes depend on location of neurostimulation in Parkinson’s disease
000865394 260__ $$aOxford$$bOxford Univ. Press$$c2019
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000865394 520__ $$aDeep 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.
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000865394 7001_ $$0P:(DE-HGF)0$$aKrause, Max$$b1
000865394 7001_ $$0P:(DE-HGF)0$$aDembek, Till A$$b2
000865394 7001_ $$00000-0002-0695-6025$$aHorn, Andreas$$b3
000865394 7001_ $$0P:(DE-HGF)0$$aEvans, Julian$$b4
000865394 7001_ $$0P:(DE-HGF)0$$aAshkan, Keyoumars$$b5
000865394 7001_ $$0P:(DE-HGF)0$$aRizos, Alexandra$$b6
000865394 7001_ $$0P:(DE-HGF)0$$aSilverdale, Monty$$b7
000865394 7001_ $$0P:(DE-HGF)0$$aSchumacher, Wibke$$b8
000865394 7001_ $$0P:(DE-HGF)0$$aSack, Carolin$$b9
000865394 7001_ $$0P:(DE-HGF)0$$aLoehrer, Philipp A$$b10
000865394 7001_ $$0P:(DE-Juel1)131720$$aFink, Gereon R$$b11
000865394 7001_ $$0P:(DE-HGF)0$$aFonoff, Erich T$$b12
000865394 7001_ $$0P:(DE-HGF)0$$aMartinez-Martin, Pablo$$b13
000865394 7001_ $$0P:(DE-HGF)0$$aAntonini, Angelo$$b14
000865394 7001_ $$0P:(DE-Juel1)131613$$aBarbe, Michael T$$b15
000865394 7001_ $$0P:(DE-HGF)0$$aVisser-Vandewalle, Veerle$$b16
000865394 7001_ $$0P:(DE-HGF)0$$aRay-Chaudhuri, K.$$b17
000865394 7001_ $$0P:(DE-HGF)0$$aTimmermann, Lars$$b18
000865394 7001_ $$0P:(DE-HGF)0$$aDafsari, Haidar S$$b19
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000865394 8564_ $$uhttps://juser.fz-juelich.de/record/865394/files/Petry_Schmelzer_2019_Post%20Print_Brain_Non-motor%20outcomes%20depend%20on%20location%20of%20neurostimulation%20in%20Parkinson%27s%20disease.pdf$$yPublished on 2019-09-23. Available in OpenAccess from 2020-09-23.
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