Friederike Irmen1,2,3, Andreas Horn1, Philip Mosley4,5, Alistair Perry6,7, Jan Niklas Petry-Schmelzer8, Haidar S Dafsari8, Michael Barbe8, Veerle Visser-Vandewalle9, Gerd-Helge Schneider10, Ningfei Li1, Dorothee Kübler1, Gregor Wenzel1, Andrea A Kühn1,2,11. 1. Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany. 2. Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany. 3. Department of Biological Psychology and Cognitive Neuroscience, Freie Universität Berlin, Berlin, Germany. 4. Systems Neuroscience Group, QIMR Berghofer Medical Research Institute, Herston, Australia. 5. Queensland Brain Institute, University of Queensland, St. Lucia, Australia. 6. Max Planck UCL Centre for Computational Psychiatry and Ageing Research, Max Planck Institute for Human Development, Berlin, Germany. 7. Center for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, Germany. 8. Faculty of Medicine and University Hospital Cologne, Department of Neurology, University of Cologne, Cologne, Germany. 9. Department of Stereotactic and Functional Neurosurgery, University Hospital Cologne, Cologne, Germany. 10. Department of Neurosurgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany. 11. Deutsches Zentrum für Neurodegenerative Erkrankungen, Berlin, Germany.
Abstract
OBJECTIVE: Subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson's disease (PD) not only stimulates focal target structures but also affects distributed brain networks. The impact this network modulation has on non-motor DBS effects is not well-characterized. By focusing on the affective domain, we systematically investigate the impact of electrode placement and associated structural connectivity on changes in depressive symptoms following STN-DBS, which have been reported to improve, worsen, or remain unchanged. METHODS: Depressive symptoms before and after STN-DBS surgery were documented in 116 patients with PD from 3 DBS centers (Berlin, Queensland, and Cologne). Based on individual electrode reconstructions, the volumes of tissue activated (VTAs) were estimated and combined with normative connectome data to identify structural connections passing through VTAs. Berlin and Queensland cohorts formed a training and cross-validation dataset used to identify structural connectivity explaining change in depressive symptoms. The Cologne data served as the test-set for which depressive symptom change was predicted. RESULTS: Structural connectivity was linked to depressive symptom change under STN-DBS. An optimal connectivity map trained on the Berlin cohort could predict changes in depressive symptoms in Queensland patients and vice versa. Furthermore, the joint training-set map predicted changes in depressive symptoms in the independent test-set. Worsening of depressive symptoms was associated with left prefrontal connectivity. INTERPRETATION: Fibers connecting the electrode with left prefrontal areas were associated with worsening of depressive symptoms. Our results suggest that for the left STN-DBS lead, placement impacting fibers to left prefrontal areas should be avoided to maximize improvement of depressive symptoms. ANN NEUROL 2020;87:962-975.
OBJECTIVE: Subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson's disease (PD) not only stimulates focal target structures but also affects distributed brain networks. The impact this network modulation has on non-motor DBS effects is not well-characterized. By focusing on the affective domain, we systematically investigate the impact of electrode placement and associated structural connectivity on changes in depressive symptoms following STN-DBS, which have been reported to improve, worsen, or remain unchanged. METHODS:Depressive symptoms before and after STN-DBS surgery were documented in 116 patients with PD from 3 DBS centers (Berlin, Queensland, and Cologne). Based on individual electrode reconstructions, the volumes of tissue activated (VTAs) were estimated and combined with normative connectome data to identify structural connections passing through VTAs. Berlin and Queensland cohorts formed a training and cross-validation dataset used to identify structural connectivity explaining change in depressive symptoms. The Cologne data served as the test-set for which depressive symptom change was predicted. RESULTS: Structural connectivity was linked to depressive symptom change under STN-DBS. An optimal connectivity map trained on the Berlin cohort could predict changes in depressive symptoms in Queensland patients and vice versa. Furthermore, the joint training-set map predicted changes in depressive symptoms in the independent test-set. Worsening of depressive symptoms was associated with left prefrontal connectivity. INTERPRETATION: Fibers connecting the electrode with left prefrontal areas were associated with worsening of depressive symptoms. Our results suggest that for the left STN-DBS lead, placement impacting fibers to left prefrontal areas should be avoided to maximize improvement of depressive symptoms. ANN NEUROL 2020;87:962-975.
Authors: Bryan Howell; Faical Isbaine; Jon T Willie; Enrico Opri; Robert E Gross; Coralie De Hemptinne; Philip A Starr; Cameron C McIntyre; Svjetlana Miocinovic Journal: Brain Stimul Date: 2021-03-20 Impact factor: 8.955
Authors: Stefanie T Jost; Veerle Visser-Vandewalle; Alexandra Rizos; Philipp A Loehrer; Monty Silverdale; Julian Evans; Michael Samuel; Jan Niklas Petry-Schmelzer; Anna Sauerbier; Alexandra Gronostay; Michael T Barbe; Gereon R Fink; Keyoumars Ashkan; Angelo Antonini; Pablo Martinez-Martin; K Ray Chaudhuri; Lars Timmermann; Haidar S Dafsari Journal: NPJ Parkinsons Dis Date: 2021-06-08
Authors: Tim A M Bouwens van der Vlis; Linda Ackermans; Anne E P Mulders; Casper A Vrij; Koen Schruers; Yasin Temel; Annelien Duits; Albert F G Leentjens Journal: Neuromodulation Date: 2020-12-25