Eraifej John, Cabral Joana, Fernandes Henrique M, Kahan Joshua, He Shenghong, Mancini Laura, Thornton John, White Mark, Yousry Tarek, Zrinzo Ludvic, Akram Harith, Limousin Patricia, Foltynie Tom, Aziz Tipu Z, Deco Gustavo, Kringelbach Morten, Green Alexander L
Oxford Functional Neurosurgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom.
Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.
Netw Neurosci. 2023 Jun 30;7(2):478-495. doi: 10.1162/netn_a_00297. eCollection 2023.
Beyond the established effects of subthalamic nucleus deep brain stimulation (STN-DBS) in reducing motor symptoms in Parkinson's disease, recent evidence has highlighted the effect on non-motor symptoms. However, the impact of STN-DBS on disseminated networks remains unclear. This study aimed to perform a quantitative evaluation of network-specific modulation induced by STN-DBS using Leading Eigenvector Dynamics Analysis (LEiDA). We calculated the occupancy of resting-state networks (RSNs) in functional MRI data from 10 patients with Parkinson's disease implanted with STN-DBS and statistically compared between ON and OFF conditions. STN-DBS was found to specifically modulate the occupancy of networks overlapping with limbic RSNs. STN-DBS significantly increased the occupancy of an orbitofrontal limbic subsystem with respect to both DBS OFF ( = 0.0057) and 49 age-matched healthy controls ( = 0.0033). Occupancy of a diffuse limbic RSN was increased with STN-DBS OFF when compared with healthy controls ( = 0.021), but not when STN-DBS was ON, which indicates rebalancing of this network. These results highlight the modulatory effect of STN-DBS on components of the limbic system, particularly within the orbitofrontal cortex, a structure associated with reward processing. These results reinforce the value of quantitative biomarkers of RSN activity in evaluating the disseminated impact of brain stimulation techniques and the personalization of therapeutic strategies.
除了丘脑底核深部脑刺激(STN-DBS)在减轻帕金森病运动症状方面已确定的效果外,最近的证据突出了其对非运动症状的影响。然而,STN-DBS对弥散网络的影响仍不清楚。本研究旨在使用主导特征向量动力学分析(LEiDA)对STN-DBS诱导的网络特异性调制进行定量评估。我们计算了10例植入STN-DBS的帕金森病患者功能磁共振成像(fMRI)数据中静息态网络(RSNs)的占有率,并在刺激开启和关闭状态之间进行了统计学比较。发现STN-DBS特异性地调节与边缘RSNs重叠的网络的占有率。与刺激关闭状态(P = 0.0057)和49名年龄匹配的健康对照(P = 0.0033)相比,STN-DBS显著增加了眶额边缘子系统的占有率。与健康对照相比,刺激关闭时弥漫性边缘RSN的占有率增加(P = 0.021),但刺激开启时没有增加,这表明该网络的重新平衡。这些结果突出了STN-DBS对边缘系统组成部分的调节作用,特别是在与奖赏处理相关的眶额皮质内。这些结果强化了RSN活动的定量生物标志物在评估脑刺激技术的弥散影响和治疗策略个性化方面的价值。