Li Ziyu, Liu Zhiqin, Gao Yuan, Tang Biqiu, Gu Shi, Luo Chunyan, Lui Su
Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Guoxue Xiang, Chengdu, China.
Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Guoxue Xiang, Chengdu, China.
Front Neurosci. 2024 Nov 7;18:1433577. doi: 10.3389/fnins.2024.1433577. eCollection 2024.
Considering the high economic burden and risks of deep brain stimulation (DBS) surgical failure, predicting the motor outcomes of DBS in Parkinson's disease (PD) is of significant importance in clinical decision-making. Functional controllability provides a rationale for combining the abnormal connections of the cortico-striato-thalamic-cortical (CSTC) motor loops and dynamic changes after medication in DBS outcome prediction.
In this study, we analyzed the association between preoperative delta functional controllability after medication within CSTC loops and motor outcomes of subthalamic nucleus DBS (STN-DBS) and globus pallidus interna DBS (GPi-DBS) and predicted motor outcomes in a Support Vector Regression (SVR) model using the delta controllability of focal regions.
While the STN-DBS motor outcomes were associated with the delta functional controllability of the thalamus, the GPi-DBS motor outcomes were related to the delta functional controllability of the caudate nucleus and postcentral gyrus. In the SVR model, the predicted and actual motor outcomes were positively correlated, with = 0.020 and = 0.514 in the STN-DBS group, and = 0.011 and = 0.705 in the GPi- DBS group.
Our findings indicate that different focal regions within the CSTC motor loops are involved in STN-DBS and GPi-DBS and support the feasibility of functional controllability in predicting DBS motor outcomes for PD in clinical decision-making.
考虑到脑深部电刺激（DBS）手术失败带来的高经济负担和风险，预测帕金森病（PD）患者DBS的运动结局在临床决策中具有重要意义。功能可控性为在DBS结局预测中结合皮质 - 纹状体 - 丘脑 - 皮质（CSTC）运动环路的异常连接及药物治疗后的动态变化提供了理论依据。
在本研究中，我们分析了CSTC环路内药物治疗后术前δ功能可控性与丘脑底核DBS（STN - DBS）和苍白球内侧部DBS（GPi - DBS）运动结局之间的关联，并使用局部区域的δ可控性在支持向量回归（SVR）模型中预测运动结局。
STN - DBS的运动结局与丘脑的δ功能可控性相关，而GPi - DBS的运动结局与尾状核和中央后回的δ功能可控性有关。在SVR模型中，预测的和实际的运动结局呈正相关，STN - DBS组中r = 0.020，R² = 0.514，GPi - DBS组中r = 0.011，R² = 0.705。
我们的研究结果表明，CSTC运动环路内不同的局部区域参与了STN - DBS和GPi - DBS，并支持功能可控性在预测PD患者DBS运动结局以用于临床决策中的可行性。
