Abstract
Parkinson’s disease (PD) is a neurodegenerative disease that is associated with motor and non-motor symptoms and caused by lack of dopamine in the substantia nigra of the brain. Subthalamic nucleus deep brain stimulation (STN-DBS) is a widely accepted therapy of PD that mainly inserts electrodes into both sides of the brain. The effect of STN-DBS was mainly for motor function, so this study focused on the recovery of motor function for PD after DBS. Hemispherical asymmetry in the brain network is considered to be a potential indicator for diagnosing PD patients. This study investigated the value of hemispheric brain connection asymmetry in predicting the DBS surgery outcome in PD patients. Four types of brain connections, including left intra-hemispheric (LH) connection, right intra-hemispheric (RH) connection, inter-hemispheric homotopic (Ho) connection, and inter-hemispheric heterotopic (He) connection, were constructed based on the resting state functional magnetic resonance imaging (rs-fMRI) performed before the DBS surgery. We used random forest for selecting features and the Ridge model for predicting surgical outcome (i.e., improvement rate of motor function). The functional connectivity analysis showed that the brain has a right laterality: the RH networks has the best correlation (r = 0.37, p = 5.68E-03) between the predicted value and the true value among the above four connections. Moreover, the region-of-interest (ROI) analysis indicated that the medioventral occipital cortex (MVOcC)–superior temporal gyrus (STG) and thalamus (Tha)–precentral gyrus (PrG) contributed most to the outcome prediction model for DBS without medication. This result provides more support for PD patients to evaluate DBS before surgery.
Highlights
Parkinson’s disease (PD) is a common degenerative disease of the nervous system, including motor symptoms such as retardation, tremor, and muscle rigidity and non-motor symptoms
Research involving the prediction of brain asymmetry in PD patients had different statistical indicators from this study that were based on the value of voxel-mirrored homotopic connectivity to assess the asymmetry of the hemispheric function and its morphology (Gan et al, 2020), and there were different prediction methods from this study using the human connectome as a connectivity profile (Horn et al, 2017)
In the Ho and He networks, the top 10 predictive connections were all distributed in the inferior frontal gyrus (IFG), middle frontal gyrus (MFG), and superior frontal gyrus. These results indicated that the frontal lobe of the Ho and He networks played an important role in predicting the DBS outcome
Summary
Parkinson’s disease (PD) is a common degenerative disease of the nervous system, including motor symptoms such as retardation, tremor, and muscle rigidity and non-motor symptoms. Subthalamic nucleus deep brain stimulation (STNDBS) is a widely accepted therapy for PD, especially when the dopaminergic replacement therapy is unsatisfactory (KleinerFisman et al, 2006). This technique was used in the pallidum and the STN (Benabid, 2003). DBS can significantly reduce the freeing of gait (Xie et al, 2012), tremor, dyskinesia, or postural instability (Weaver et al, 2005) and thereby improve the quality of life. DBS can reduce the non-motor symptoms (Hwynn et al, 2011) in PD patients. How to evaluate the possible therapeutic improvement of each patient especially before the surgery is a question that deserves serious consideration
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