Pub Date : 2025-12-11DOI: 10.1016/j.jdbs.2025.12.002
Abdelhamid Benazzouz
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) has revolutionized the treatment of Parkinson’s disease. It is considered as a treatment of choice, after Levodopa, for patients suffering from advanced stages of the disease. Thanks to fundamental and preclinical research on animal models, notably the MPTP monkey, we were able to demonstrate that the STN is a target structure for surgery, and then that high-frequency electrical stimulation (HFS) of the STN dramatically improved the cardinal motor symptoms of Parkinson's disease, without major side-effects. These seminal works paved the way for a new surgical approach to Parkinson's disease, which involves implanting electrodes in the STN in Parkinson's patients suffering from advanced stages of the disease. In this chapter, we describe the key historical milestones that enabled the development of DBS in Parkinson's disease, focusing on its old and new era.
{"title":"The quest for a target and the beginning of the DBS-story","authors":"Abdelhamid Benazzouz","doi":"10.1016/j.jdbs.2025.12.002","DOIUrl":"10.1016/j.jdbs.2025.12.002","url":null,"abstract":"<div><div>Deep brain stimulation (DBS) of the subthalamic nucleus (STN) has revolutionized the treatment of Parkinson’s disease. It is considered as a treatment of choice, after Levodopa, for patients suffering from advanced stages of the disease. Thanks to fundamental and preclinical research on animal models, notably the MPTP monkey, we were able to demonstrate that the STN is a target structure for surgery, and then that high-frequency electrical stimulation (HFS) of the STN dramatically improved the cardinal motor symptoms of Parkinson's disease, without major side-effects. These seminal works paved the way for a new surgical approach to Parkinson's disease, which involves implanting electrodes in the STN in Parkinson's patients suffering from advanced stages of the disease. In this chapter, we describe the key historical milestones that enabled the development of DBS in Parkinson's disease, focusing on its old and new era.</div></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"12 ","pages":"Pages 9-15"},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chronic pain is a major public health issue, and despite advances in understanding its pathophysiology, current treatments remain insufficient, significantly affecting patients' quality of life. Existing therapies, including opioids, antidepressants and non-steroidal anti-inflammatory drugs, target specific mechanisms but fail to address the multifactorial nature of chronic pain, which is often accompanied by comorbidities like depression and anxiety. In cases like neuropathic pain, where pharmacological treatments are ineffective, alternatives such as deep brain stimulation (DBS) have gained attention. Although widely used for movement disorders, particularly in Parkinson's disease, DBS has the potential to treat pain by targeting identified deep brain structures while minimizing side effects. Neuropathic pain is linked to changes in several brain networks making up the so-called pain matrix, which includes the thalamus, the cornerstone of sensory, emotional and cognitive dimensions. This review focuses on the use of DBS of the thalamus and closely associated brain structures, such as the periaqueductal and periventricular gray, anterior cingulate cortex and insula, to treat pain.
{"title":"Targeting pain with deep brain stimulation: Insights into the thalamus and associated structures","authors":"Rabia Bouali-Benazzouz , Pascal Fossat , Abdelhamid Benazzouz","doi":"10.1016/j.jdbs.2025.12.001","DOIUrl":"10.1016/j.jdbs.2025.12.001","url":null,"abstract":"<div><div>Chronic pain is a major public health issue, and despite advances in understanding its pathophysiology, current treatments remain insufficient, significantly affecting patients' quality of life. Existing therapies, including opioids, antidepressants and non-steroidal anti-inflammatory drugs, target specific mechanisms but fail to address the multifactorial nature of chronic pain, which is often accompanied by comorbidities like depression and anxiety. In cases like neuropathic pain, where pharmacological treatments are ineffective, alternatives such as deep brain stimulation (DBS) have gained attention. Although widely used for movement disorders, particularly in Parkinson's disease, DBS has the potential to treat pain by targeting identified deep brain structures while minimizing side effects. Neuropathic pain is linked to changes in several brain networks making up the so-called pain matrix, which includes the thalamus, the cornerstone of sensory, emotional and cognitive dimensions. This review focuses on the use of DBS of the thalamus and closely associated brain structures, such as the periaqueductal and periventricular gray, anterior cingulate cortex and insula, to treat pain.</div></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"12 ","pages":"Pages 1-8"},"PeriodicalIF":0.0,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145718975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.jdbs.2025.11.001
Massimiliano Domenico Rizzaro , Luigi Gianmaria Remore , Valeria Lo Faso , Giorgio Fiore , Luigi Schisano , Elena Pirola , Antonella Ampollini , Giulio Andrea Bertani , Stefania Elena Navone , Giovanni Marfia , Marco Locatelli
Aphasia is the disturbance of language production and/or comprehension. From 25–40 % of patients with stroke manifest aphasia. Although many rehabilitation techniques are known, a large percentage of these patients do not recover language function. In this systematic review we analyze the role of a new technique that encodes neuronal impulses and transforms them into language, Brain-Computer Interface (BCI). Through a systematic search, 7 articles considering BCI as a rehabilitation technique on 33 aphasic patients were found. Three methods were used in these studies: neurofeedback, visual P300 and auditory P300. Our results show that these three techniques are viable therapeutic alternatives to traditional speech exercises. In particular, auditory P300 was shown to be statistically superior to visual P300 in the recovery of aphasic patients.
{"title":"Rehabilitation based on brain-computer interface for aphasic patients: A systematic review","authors":"Massimiliano Domenico Rizzaro , Luigi Gianmaria Remore , Valeria Lo Faso , Giorgio Fiore , Luigi Schisano , Elena Pirola , Antonella Ampollini , Giulio Andrea Bertani , Stefania Elena Navone , Giovanni Marfia , Marco Locatelli","doi":"10.1016/j.jdbs.2025.11.001","DOIUrl":"10.1016/j.jdbs.2025.11.001","url":null,"abstract":"<div><div>Aphasia is the disturbance of language production and/or comprehension. From 25–40 % of patients with stroke manifest aphasia. Although many rehabilitation techniques are known, a large percentage of these patients do not recover language function. In this systematic review we analyze the role of a new technique that encodes neuronal impulses and transforms them into language, Brain-Computer Interface (BCI). Through a systematic search, 7 articles considering BCI as a rehabilitation technique on 33 aphasic patients were found. Three methods were used in these studies: neurofeedback, visual P300 and auditory P300. Our results show that these three techniques are viable therapeutic alternatives to traditional speech exercises. In particular, auditory P300 was shown to be statistically superior to visual P300 in the recovery of aphasic patients.</div></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"11 ","pages":"Pages 18-24"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-16DOI: 10.1016/j.jdbs.2025.10.002
Laurens A. Biesheuvel , Jesús Fuentes , Rob M.A. de Bie , Bernadette C.M. van Wijk , P. Rick Schuurman , Andreas Husch , Jorge Goncalves , Martijn Beudel
Deep brain stimulation (DBS) targeting the subthalamic nucleus (STN) is an established therapy for advanced Parkinson’s disease (PD), but outcomes vary significantly among patients. Using a dataset of 408–420 PD patients (depending on outcome), we developed machine learning models to predict outcomes of STN-DBS based on preoperative clinical markers. Regression models predicted scores on the Movement Disorders Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) part III, and subscores for Tremor, Axial symptoms, and Bradykinesia & Rigidity. The models achieved root mean square errors (RMSE) of 9.1, 2.6, 2.5, and 5.3, respectively. These results demonstrate the models’ ability to provide accurate predictions despite the heterogeneity of PD. This approach refines patient selection by forecasting postoperative outcomes and enables personalized treatment planning. Future iterations will explore additional predictors, such as neuroimaging data, to further improve model performance and support clinical decision-making in DBS therapy. This study advances the use of machine learning in predictive medicine for PD.
{"title":"Prediction of STN-DBS outcome in Parkinson’s disease using machine learning","authors":"Laurens A. Biesheuvel , Jesús Fuentes , Rob M.A. de Bie , Bernadette C.M. van Wijk , P. Rick Schuurman , Andreas Husch , Jorge Goncalves , Martijn Beudel","doi":"10.1016/j.jdbs.2025.10.002","DOIUrl":"10.1016/j.jdbs.2025.10.002","url":null,"abstract":"<div><div>Deep brain stimulation (DBS) targeting the subthalamic nucleus (STN) is an established therapy for advanced Parkinson’s disease (PD), but outcomes vary significantly among patients. Using a dataset of 408–420 PD patients (depending on outcome), we developed machine learning models to predict outcomes of STN-DBS based on preoperative clinical markers. Regression models predicted scores on the Movement Disorders Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) part III, and subscores for Tremor, Axial symptoms, and Bradykinesia & Rigidity. The models achieved root mean square errors (RMSE) of 9.1, 2.6, 2.5, and 5.3, respectively. These results demonstrate the models’ ability to provide accurate predictions despite the heterogeneity of PD. This approach refines patient selection by forecasting postoperative outcomes and enables personalized treatment planning. Future iterations will explore additional predictors, such as neuroimaging data, to further improve model performance and support clinical decision-making in DBS therapy. This study advances the use of machine learning in predictive medicine for PD.</div></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"11 ","pages":"Pages 1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-06DOI: 10.1016/j.jdbs.2025.10.001
David Dominguez-Paredes, Berkhan Genc, Yasin Temel, Ali Jahanshahi
Deep brain stimulation (DBS) has evolved through a dynamic interplay between clinical and pre-clinical research. Initially inspired by invasive clinical practices such as ablations, resections, and other lesion-based interventions, minimally-invasive electrical stimulation was subsequently discovered and explored across numerous clinical and pre-clinical investigations. As a result, both human subjects and animal models are commonly utilized to advance the understanding, refinement, and use cases of DBS and its new variants. In this review, we examine some of the most significant contributions of pre-clinical models to the development of DBS, while also addressing key translational challenges and considerations necessary to maximize the impact of these efforts in the clinic. We conclude that, although findings from animal studies are often difficult to directly apply in the clinical setting, they remain an essential complementary strategy for uncovering DBS insights that would be impractical or unethical to pursue with human trials.
{"title":"Contribution of animal models to DBS research in movement and psychiatric disorders: A review","authors":"David Dominguez-Paredes, Berkhan Genc, Yasin Temel, Ali Jahanshahi","doi":"10.1016/j.jdbs.2025.10.001","DOIUrl":"10.1016/j.jdbs.2025.10.001","url":null,"abstract":"<div><div>Deep brain stimulation (DBS) has evolved through a dynamic interplay between clinical and pre-clinical research. Initially inspired by invasive clinical practices such as ablations, resections, and other lesion-based interventions, minimally-invasive electrical stimulation was subsequently discovered and explored across numerous clinical and pre-clinical investigations. As a result, both human subjects and animal models are commonly utilized to advance the understanding, refinement, and use cases of DBS and its new variants. In this review, we examine some of the most significant contributions of pre-clinical models to the development of DBS, while also addressing key translational challenges and considerations necessary to maximize the impact of these efforts in the clinic. We conclude that, although findings from animal studies are often difficult to directly apply in the clinical setting, they remain an essential complementary strategy for uncovering DBS insights that would be impractical or unethical to pursue with human trials.</div></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"11 ","pages":"Pages 10-17"},"PeriodicalIF":0.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-05DOI: 10.1016/j.jdbs.2025.08.001
Jackson Tyler Boonstra , Berkhan Genç
Recent advancements in neuroimaging have revolutionized the field of deep brain stimulation (DBS), enabling unprecedented precision in target identification, surgical planning, and post-operative assessment. This review synthesizes the latest innovations in MRI-based and multimodal imaging approaches, with a focus on high-field MRI, susceptibility-weighted imaging (SWI), quantitative susceptibility mapping (QSM), and novel image processing techniques including connectomics. We discuss how these technologies have enhanced visualization of deep brain nuclei and vascular structures, improved the integration of anatomical and functional data, and enabled more individualized DBS therapy. Key challenges, including imaging safety with implanted devices and the limitations of current imaging in functional mapping, are critically evaluated. By emphasizing recent breakthroughs and future prospects, this review provides a roadmap for harnessing neuroimaging to optimize DBS outcomes and expand its therapeutic potential.
{"title":"Neuroimaging in deep brain stimulation: Bridging technical progress with clinical practice","authors":"Jackson Tyler Boonstra , Berkhan Genç","doi":"10.1016/j.jdbs.2025.08.001","DOIUrl":"10.1016/j.jdbs.2025.08.001","url":null,"abstract":"<div><div>Recent advancements in neuroimaging have revolutionized the field of deep brain stimulation (DBS), enabling unprecedented precision in target identification, surgical planning, and post-operative assessment. This review synthesizes the latest innovations in MRI-based and multimodal imaging approaches, with a focus on high-field MRI, susceptibility-weighted imaging (SWI), quantitative susceptibility mapping (QSM), and novel image processing techniques including connectomics. We discuss how these technologies have enhanced visualization of deep brain nuclei and vascular structures, improved the integration of anatomical and functional data, and enabled more individualized DBS therapy. Key challenges, including imaging safety with implanted devices and the limitations of current imaging in functional mapping, are critically evaluated. By emphasizing recent breakthroughs and future prospects, this review provides a roadmap for harnessing neuroimaging to optimize DBS outcomes and expand its therapeutic potential.</div></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"10 ","pages":"Pages 41-49"},"PeriodicalIF":0.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Recent advances in neural engineering have deepened our insight into the relationship between neural activity, brain circuits, and behaviour, paving the way for new neuromodulation strategies. Techniques such as optogenetics and chemogenetics, alongside external stimulation techniques such as deep brain stimulation (DBS), have enabled activation and inhibition of neurons. However, these methods are often limited by their invasiveness, potential off-target effects, and challenges in temporal resolution. Existing non-invasive approaches, such as transcranial magnetic stimulation and focused ultrasound (FUS), show clinical promise but are constrained by spatial precision and stimulation depth limitations in the brain. Magnetic nanomaterials offer a promising, minimally invasive alternative by directly interacting with the nervous system at cellular and molecular levels. When exposed to external magnetic fields (MFs), these nanoscale materials can modulate neuronal activity through mechanisms such as localised electric polarisation (magnetoelectric), heat dissipation (magnetothermal), or mechanical force via magnetic moment (magnetomechanical), enabling targeted neuronal excitation or inhibition. To advance this technology, future research is needed to optimise nanomaterial biocompatibility, particularly through surface coatings, and on developing compact, wearable systems to replace existing stationary and bulky electronics that drive MFs for minimally invasive neuromodulation.
{"title":"Minimally invasive neuromodulation using magnetic nanomaterials","authors":"Anouk Wolters , Danijela Gregurec , Sarah-Anna Hescham","doi":"10.1016/j.jdbs.2025.07.002","DOIUrl":"10.1016/j.jdbs.2025.07.002","url":null,"abstract":"<div><div>Recent advances in neural engineering have deepened our insight into the relationship between neural activity, brain circuits, and behaviour, paving the way for new neuromodulation strategies. Techniques such as optogenetics and chemogenetics, alongside external stimulation techniques such as deep brain stimulation (DBS), have enabled activation and inhibition of neurons. However, these methods are often limited by their invasiveness, potential off-target effects, and challenges in temporal resolution. Existing non-invasive approaches, such as transcranial magnetic stimulation and focused ultrasound (FUS), show clinical promise but are constrained by spatial precision and stimulation depth limitations in the brain. Magnetic nanomaterials offer a promising, minimally invasive alternative by directly interacting with the nervous system at cellular and molecular levels. When exposed to external magnetic fields (MFs), these nanoscale materials can modulate neuronal activity through mechanisms such as localised electric polarisation (magnetoelectric), heat dissipation (magnetothermal), or mechanical force via magnetic moment (magnetomechanical), enabling targeted neuronal excitation or inhibition. To advance this technology, future research is needed to optimise nanomaterial biocompatibility, particularly through surface coatings, and on developing compact, wearable systems to replace existing stationary and bulky electronics that drive MFs for minimally invasive neuromodulation.</div></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"10 ","pages":"Pages 24-32"},"PeriodicalIF":0.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144829990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-10DOI: 10.1016/j.jdbs.2025.07.001
David Dominguez-Paredes, Berkhan Genc, Ali Jahanshahi
Deep brain stimulation (DBS) has evolved through a dynamic interplay between clinical and pre-clinical research. Initially inspired by invasive clinical practices such as ablations, resections, and other lesion-based interventions, minimally-invasive electrical stimulation was subsequently discovered and explored across numerous clinical and pre-clinical investigations. As a result, both human subjects and animal models are commonly utilized to advance the understanding, refinement, and use cases of DBS and its new variants. In this review, we examine some of the most significant contributions of pre-clinical models to the development of DBS, while also addressing key translational challenges and considerations necessary to maximize the impact of these efforts in the clinic. We conclude that, although findings from animal studies are often difficult to directly apply in the clinical setting, they remain an essential complementary strategy for uncovering DBS insights that would be impractical or unethical to pursue with human trials.
{"title":"Contribution of animal models to deep brain stimulation research in movement and psychiatric disorders","authors":"David Dominguez-Paredes, Berkhan Genc, Ali Jahanshahi","doi":"10.1016/j.jdbs.2025.07.001","DOIUrl":"10.1016/j.jdbs.2025.07.001","url":null,"abstract":"<div><div>Deep brain stimulation (DBS) has evolved through a dynamic interplay between clinical and pre-clinical research. Initially inspired by invasive clinical practices such as ablations, resections, and other lesion-based interventions, minimally-invasive electrical stimulation was subsequently discovered and explored across numerous clinical and pre-clinical investigations. As a result, both human subjects and animal models are commonly utilized to advance the understanding, refinement, and use cases of DBS and its new variants. In this review, we examine some of the most significant contributions of pre-clinical models to the development of DBS, while also addressing key translational challenges and considerations necessary to maximize the impact of these efforts in the clinic. We conclude that, although findings from animal studies are often difficult to directly apply in the clinical setting, they remain an essential complementary strategy for uncovering DBS insights that would be impractical or unethical to pursue with human trials.</div></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"10 ","pages":"Pages 33-40"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-19DOI: 10.1016/j.jdbs.2025.06.002
Karl Hartmann , Joanna Bielawski , Klaus-Peter Stein , Belal Neyazi , Nikolai Tonchev , Jörn Kaufmann , Dirk Schomburg , Aiden Haghikia , I. Erol Sandalcioglu , Jürgen Voges
Background
MRI diffusion measures have been shown to be valuable imaging tools for assessing neuronal degeneration in vivo. In idiopathic Parkinson's disease, diffusion measures of mesencephalic nuclei appeared to correlate with disease manifestations. However, large selective cohorts are lacking to define the clinical relevance of such potential MRI biomarkers.
Method
This study investigates the relevance of 3 Tesla diffusion MRI of the subthalamic nucleus (STN) as a potential imaging biomarker. Experts in deep brain stimulation manually segmented the STN on T2-weighted 3 T MRI scans to create templates for measuring mean diffusivity and fractional anisotropy on aligned diffusion-weighted MRI scans.
Results
Demographic data, including age, sex, handedness, and specifications of neurological symptoms such as motor deficit severity, were collected using the Unified Parkinson’s Disease Rating Scale in 130 patients at disease onset and progression. Despite a homogeneous study cohort no statistically significant correlations were found between local diffusion measures of the STN and contralateral clinical parameters.
Conclusion
Unlike previous studies that suggested potential correlations between mesencephalic diffusion measures and disease manifestations, this study did not confirm such associations for the subthalamic nucleus at 3 T MRI in a large and homogeneous patient cohort. In the future research might focus on patients in earlier stages of the disease and employ higher field strength MRIs with increased spatial resolution to investigate the clinical relevance of MRI diffusion measures of the STN region in Parkinson's disease.
mri弥散测量已被证明是评估体内神经元变性的有价值的成像工具。在特发性帕金森病中，中脑核的扩散测量似乎与疾病表现相关。然而，缺乏大量的选择性队列来确定这些潜在的MRI生物标志物的临床相关性。方法探讨丘脑底核（STN） 3特斯拉扩散MRI作为潜在的成像生物标志物的相关性。脑深部刺激专家手动分割t2加权3 T MRI扫描上的STN，以创建用于测量定向扩散加权MRI扫描上的平均扩散率和分数各向异性的模板。结果使用统一帕金森病评定量表收集了130例发病和进展的患者的人口统计数据，包括年龄、性别、利手性和神经系统症状（如运动缺陷严重程度）。尽管是同质研究队列，但没有发现STN局部弥散测量与对侧临床参数之间有统计学意义的相关性。与先前的研究表明中脑弥散测量与疾病表现之间的潜在相关性不同，本研究没有在一个大的、均匀的患者队列中通过3 T MRI证实丘脑下核的这种关联。未来的研究可能会集中在疾病早期阶段的患者，采用更高场强、更高空间分辨率的MRI来研究帕金森病STN区MRI弥散测量的临床意义。
{"title":"No significant correlation of subthalamic nuclei diffusion measures and disease burden: Evidence from 130 Parkinson’s Disease Cases","authors":"Karl Hartmann , Joanna Bielawski , Klaus-Peter Stein , Belal Neyazi , Nikolai Tonchev , Jörn Kaufmann , Dirk Schomburg , Aiden Haghikia , I. Erol Sandalcioglu , Jürgen Voges","doi":"10.1016/j.jdbs.2025.06.002","DOIUrl":"10.1016/j.jdbs.2025.06.002","url":null,"abstract":"<div><h3>Background</h3><div>MRI diffusion measures have been shown to be valuable imaging tools for assessing neuronal degeneration in vivo. In idiopathic Parkinson's disease, diffusion measures of mesencephalic nuclei appeared to correlate with disease manifestations. However, large selective cohorts are lacking to define the clinical relevance of such potential MRI biomarkers.</div></div><div><h3>Method</h3><div>This study investigates the relevance of 3 Tesla diffusion MRI of the subthalamic nucleus (STN) as a potential imaging biomarker. Experts in deep brain stimulation manually segmented the STN on T2-weighted 3 T MRI scans to create templates for measuring mean diffusivity and fractional anisotropy on aligned diffusion-weighted MRI scans.</div></div><div><h3>Results</h3><div>Demographic data, including age, sex, handedness, and specifications of neurological symptoms such as motor deficit severity, were collected using the Unified Parkinson’s Disease Rating Scale in 130 patients at disease onset and progression. Despite a homogeneous study cohort no statistically significant correlations were found between local diffusion measures of the STN and contralateral clinical parameters.</div></div><div><h3>Conclusion</h3><div>Unlike previous studies that suggested potential correlations between mesencephalic diffusion measures and disease manifestations, this study did not confirm such associations for the subthalamic nucleus at 3 T MRI in a large and homogeneous patient cohort. In the future research might focus on patients in earlier stages of the disease and employ higher field strength MRIs with increased spatial resolution to investigate the clinical relevance of MRI diffusion measures of the STN region in Parkinson's disease.</div></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"10 ","pages":"Pages 1-12"},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-03DOI: 10.1016/j.jdbs.2025.06.001
Ramesh Perumal , Jenq-Wei Yang , Yu-Hsiu Kuo , Vincent Vigneron , Hsing-Hua Ho , Hugues Almorin , Chi-Fen Chuang , Yen-Chung Chang , Shih-Rung Yeh , Hsin Chen
The increase of high-voltage spindles (HVSs) in the basal ganglia network is a hallmark of dopamine depletion in Parkinsonian rats. Emerging evidence highlights the efficacy of deep brain stimulation (DBS) in suppressing HVSs. It is of significant interest to investigate whether suppressing HVSs can mitigate pathological neuron synchrony in the basal ganglia, particularly in early-stage Parkinson's disease. To effectively suppress HVSs using DBS, we developed a closed-loop stimulator triggered by HVS occurrence. Based on autoregressive modeling at intervals, a predictive model was created with parameters trainable offline using the Kalman filter to detect the onset of HVSs, which is suitable for hardware implementation. This model identified all 1131 HVS episodes from four Parkinsonian rats using 144 ms of preceding data, achieving a 94 % mean precision and a mean latency of 72 ms—well below the average HVS duration of 4.3 s. Additionally, it achieves comparable latency while requiring 95 % less computational time than the previous wavelet-based HVS detection model. With the trained model implemented in a microcontroller, we further investigated the effects of closed-loop DBS (cDBS) on HVSs in free-moving Parkinsonian rats with a tethered and wireless system, respectively. In both setups, a stimulation duration as brief as 0.2 s effectively suppressed HVSs. Furthermore, using the wireless system, the inhibition of HVS lasted over 30 min post-cDBS application. These findings underscore the potential of cDBS to suppress HVSs, lower stimulation dosages, and reduce side effects, paving the way for its application in early-stage Parkinson's disease treatment through neuromodulation.
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