TY  - JOUR
AU  - Petry-Schmelzer, Jan Niklas
AU  - Krause, Max
AU  - Dembek, Till A
AU  - Horn, Andreas
AU  - Evans, Julian
AU  - Ashkan, Keyoumars
AU  - Rizos, Alexandra
AU  - Silverdale, Monty
AU  - Schumacher, Wibke
AU  - Sack, Carolin
AU  - Loehrer, Philipp A
AU  - Fink, Gereon R
AU  - Fonoff, Erich T
AU  - Martinez-Martin, Pablo
AU  - Antonini, Angelo
AU  - Barbe, Michael T
AU  - Visser-Vandewalle, Veerle
AU  - Ray-Chaudhuri, K.
AU  - Timmermann, Lars
AU  - Dafsari, Haidar S
TI  - Non-motor outcomes depend on location of neurostimulation in Parkinson’s disease
JO  - Brain
VL  - 142
IS  - 11
SN  - 1460-2156
CY  - Oxford
PB  - Oxford Univ. Press
M1  - FZJ-2019-04879
SP  - 3592-3604
PY  - 2019
AB  - 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.
LB  - PUB:(DE-HGF)16
C6  - pmid:31553039
UR  - <Go to ISI:>//WOS:000504323200034
DO  - DOI:10.1093/brain/awz285
UR  - https://juser.fz-juelich.de/record/865394
ER  -