npj Parkinsons Dis: fMRI, useful for discovering which Parkinsons patients are suitable for deep brain stimulation

Parkinson's disease (PD) is one of the most common neurodegenerative diseases, affecting millions of people worldwide
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It is characterized by motor symptoms, such as resting tremor, stiffness, and bradykinesia, and non-motor manifestations, including autonomic dysfunction, behavioral, and cognitive impairment

Parkinson's disease (PD) is one of the most common neurodegenerative diseases, affecting millions of people worldwide

Figure 1 Title of the paper

Figure 1 Title of the paper

The progressive death of pigment neurons in the substantia nigra is the main pathological feature
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Several treatments are currently available, including medications, surgery, and supportive care, to help relieve symptoms and maintain an acceptable quality of life

The progressive death of pigment neurons in the substantia nigra is the main pathological feature

Deep brain stimulation (DBS) has emerged as a well-established treatment for PD, and few treatments are as effective as DBS in controlling PD's troubling motor symptoms, levodopa-induced dyskinesias, and quality of life

Before recommending surgery on a given patient, the following factors must be carefully evaluated: disease duration (at least several years according to the Earlystim clinical trial), levodopa responsiveness, type and severity of motor symptoms, cognitive and psychiatric problems, comorbidities, and brain magnetic resonance imaging (MRI) findings

Recent advances in the field of neuroimaging are continually expanding our knowledge of the brain regions and circuits underlying the clinical manifestations of PD

Recently, RS-fMRI studies have shown that functional connectivity patterns can identify distinct clinical clusters of PD or predict motor benefit in DBS, and that changes in brain functional networks correlate with PD motor and cognitive severity

With this, Luigi Albano et al.

Neurological assessment and resting-state functional MRI (RS-fMRI) were performed at baseline and annually for 4 years in a prospectively recruited cohort of Parkinson's disease patients

Patients were divided into two groups: 19 patients who were eligible for DBS during follow-up and 41 who were not eligible for DBS

Patients selected as candidates for DBS did not undergo surgery at this stage

Figure 2 Schematic diagram of fMRI results

Figure 2 Schematic diagram of fMRI results

At baseline, network analysis showed higher mean nodal intensity, local efficiency, and clustering coefficient in the occipital region of DBS-eligible individuals over time relative to controls and patients who were not eligible for DBS
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The pattern of hyperconnectivity in the occipital region was confirmed by regional analysis

At baseline, network analysis showed higher mean nodal intensity, local efficiency, and clustering coefficient in the occipital region of DBS-eligible individuals over time relative to controls and patients who were not eligible for DBS
.
The pattern of hyperconnectivity in the occipital region was confirmed by regional analysis
.

At baseline, functional connectivity between the basal ganglia and the sensorimotor/prefrontal network was reduced in patients with DBS compared with patients who were not eligible for surgery
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At baseline, functional connectivity between the basal ganglia and the sensorimotor/prefrontal network was reduced in patients with DBS compared with patients who were not eligible for surgery
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In longitudinal analyses, compared with those who were not suitable for DBS, the brain tissue and functional connectivity of DBS-adapted individuals gradually decreased, mainly in the hindbrain network, while the basal ganglia network was gradually increased
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In longitudinal analyses, compared with those who were not suitable for DBS, the brain tissue and functional connectivity of DBS-adapted individuals gradually decreased, mainly in the hindbrain network, while the basal ganglia network was gradually increased
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Thus, RS-fMRI can support clinical indications for DBS and can be used to predict which patients are eligible for DBS in the early stages of PD
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Thus, RS-fMRI can support clinical indications for DBS and can be used to predict which patients are eligible for DBS in the early stages of PD
.

Original source:
Albano L, Agosta F, Basaia S, et al.
Functional connectivity in Parkinson's disease candidates for deep brain stimulation.
npj Parkinsons Dis.
2022;8(1):4.
doi:10.
1038/s41531-021-00268-6

Original source:
Albano L, Agosta F, Basaia S, et al.
Functional connectivity in Parkinson's disease candidates for deep brain stimulation.
npj Parkinsons Dis.
2022;8(1):4.
doi:10.
1038/s41531-021-00268-6 leave a message here