Resting State Functional Magnetic Resonance Brain Connection Network Predicts The Clinical Efficacy Of Deep Brain Stimulation In Parkinson’s Disease

Objective Deep brain stimulation(DBS)has been widely used clinically as a surgical treatment for Parkinson’s disease,however,the underlying mechanism of it’s efficacy remains unclear.Using f MRI as a tool,this study attempted to explore connectivity patterns associated with DBS and to explore predictors of treatment outcomes in Parkinson’s disease patients after DBS.Methods Unified-Parkinson Disease Rating Scale(UPDRS III)was used in 41 patients diagnosed with Parkinson disease and treated with deep brain stimulation.Data were collected before and one year after surgery,and compared with postoperative CT Scanning with preoperative MRI reconstruction to determine electrode placement.To examine the relationship between motor symptom improvement and brain functional connectivity,a correlation analysis of subcortical connectivity networks was performed using resting-state functional magnetic resonance imaging(rs-f MRI)data.Linear regression was then applied to predict exercise outcomes,and the accuracy of the model was validated by leave-one-out cross-validation.Results This study aimed to analyze the connections between subcortical nuclei before DBS surgery using f MRI.The study also investigated the correlation between these links and the clinical outcomes of DBS surgery in patients with Parkinson disease.The results of the study showed that after DBS surgery,the quality of life of patients was significantly improved,and functional connectivity analysis reveals significant association between bilateral red nucleus-putamen connectivity and improvement in motor symptoms(left r=-0.44,P =0.0056,right r=-0.46,P =0.0029).The combination analysis of the connection between the red nucleus and the putamen and the improvement of preoperative drugs is more accurate in predicting the improvement of postoperative motor symptoms(P< 0.001 error rate:0.175).Conclusions(1)Motor symptoms in patients with Parkinson disease improve after DBS,with a potentially additive effect of improvement with dopaminergic agents.(2)f MRI can be used as a tool to predict the outcome of DBS surgery.Combined with the improvement rate of preoperative medication,it is possible to improve the accuracy of prediction.(3)The functional connectivity between the putamen and the red nucleus can be used as a predictor of the treatment effect in Parkinson’s disease patients undergoing DBS surgery.