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  Restoration of functional network state towards more physiological condition as the correlate of clinical effects of pallidal deep brain stimulation in dystonia

Filip, P., Jech, R., Fečíková, A., Havránková, P., Růžička, F., Mueller, K., et al. (2022). Restoration of functional network state towards more physiological condition as the correlate of clinical effects of pallidal deep brain stimulation in dystonia. Brain Stimulation, 15(5), 1269-1278. doi:10.1016/j.brs.2022.08.025.

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 Creators:
Filip, Pavel1, 2, Author
Jech, Robert1, Author
Fečíková, Anna1, Author
Havránková, Petra1, Author
Růžička, Filip1, Author
Mueller, Karsten1, 3, 4, Author           
Urgošík, Dušan1, 5, Author
Affiliations:
1Department of Neurology, First Faculty of Medicine, Charles University, Prague, Czech Republic, ou_persistent22              
2Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA, ou_persistent22              
3Method and Development Group Neural Data Science and Statistical Computing, MPI for Human Cognitive and Brain Sciences, Max Planck Society, ou_3282987              
4Methods and Development Group Nuclear Magnetic Resonance, MPI for Human Cognitive and Brain Sciences, Max Planck Society, Leipzig, DE, ou_634558              
5Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech Republic, ou_persistent22              

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Free keywords: Deep brain stimulation; Dystonia; Internal globus pallidus; Resting-state functional magnetic resonance imaging; Connectivity
 Abstract: Background: Deep brain stimulation of the internal globus pallidus (GPi DBS) is an invasive therapeutic modality intended to retune abnormal central nervous system patterns and relieve the patient of dystonic or other motor symptoms.





Objectives: The aim of the presented research was to determine the neuroanatomical signature of GPi DBS modulation and its association with the clinical outcome.





Methods: This open-label fixed-order study with cross-sectional validation against healthy controls analysed the resting-state functional MRI activity changes induced by GPi DBS in 18 dystonia patients of heterogeneous aetiology, focusing on both global (full brain) and local connectivity (local signal homogeneity).





Results: Compared to the switched-off state, the activation of GPi DBS led to the restoration of global subcortical connectivity patterns (in both putamina, diencephalon and brainstem) towards those of healthy controls, with positive direct correlation over large-scale cortico-basal ganglia-thalamo-cortical and cerebellar networks with the clinical improvement. Nonetheless, on average, GPi DBS also seemed to bring local connectivity both in the cortical and subcortical regions farther away from the state detected in healthy controls. Interestingly, its correlation with clinical outcome showed that in better DBS responders, local connectivity defied this effect and approached healthy controls.





Conclusions: All in all, the extent of restoration of both these main metrics of interest towards the levels found in healthy controls clearly correlated with the clinical improvement, indicating that the restoration of network state towards more physiological condition may be a precondition for successful GPi DBS outcome in dystonia.

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Language(s): eng - English
 Dates: 2022-08-072022-03-222022-08-312022-09-092022-10
 Publication Status: Published in print
 Pages: -
 Publishing info: -
 Table of Contents: -
 Rev. Type: Peer
 Identifiers: DOI: 10.1016/j.brs.2022.08.025
Other: epub 2022
PMID: 36096443
 Degree: -

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Project name : -
Grant ID : AZV NV19-04-00233
Funding program : -
Funding organization : Czech Ministry of Health
Project name : -
Grant ID : COFUND-EJP N° 825575
Funding program : European Joint Programme on Rare Diseases
Funding organization : -

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Title: Brain Stimulation
  Abbreviation : Brain Stimul
Source Genre: Journal
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Publ. Info: New York, NY : Elsevier
Pages: - Volume / Issue: 15 (5) Sequence Number: - Start / End Page: 1269 - 1278 Identifier: ISSN: 1935-861X
CoNE: https://pure.mpg.de/cone/journals/resource/1935-861X