Category: Parkinson's disease: Neuroimaging
Objective: To identify target-specific neuroimaging biomarkers for STN and GPi DBS and evaluate their impact on the global functional hierarchy and clinical outcomes.
Background: Selection between STN and GPi targets remains empirical. While both improve motor function, their distinct effects on higher-order brain networks and subsequent impacts on cognition and speech are not fully understood.
Method: In a primary cohort (STN n=27; GPi n=28), we calculated VTA-seeded functional connectivity and analyzed global topological changes via functional gradients. After identifying target-specific reorganization patterns, we validated their clinical relevance by projecting them onto latent space of memory and language performance established via Partial least square regression in an independent external cohort (n=55).
Results: Both targets modulated motor circuits similarly (P>0.05,FDR adjusted). However, a significant divergence was identified in the transmodal hierarchy (P<0.05, FDR adjusted): GPi DBS was associated with higher prefrontal integration and lower temporal involvement (P<0.05, FDR adjusted), specifically involving the Inhibitory Control Network. When projected into the cognitive latent space, the STN-specific network pattern was significantly associated with negative modulation of language performance.
Conclusion: STN and GPi DBS exert distinct effects on the brain’s transmodal organization. The preservation of higher-order networks by GPi DBS explains its favorable cognitive profile, while STN-induced shifts in the language latent space provide an imaging biomarker for stimulation-induced speech changes.
Analysis Pipeline and Results
References: Middlebrooks, E.H., Domingo, R.A., Vivas-Buitrago, T., Okromelidze, L., Tsuboi, T., Wong, J.K., Eisinger, R.S., Almeida, L., Burns, M.R., Horn, A. and Uitti, R.J., 2020. Neuroimaging advances in deep brain stimulation: review of indications, anatomy, and brain connectomics. American Journal of Neuroradiology, 41(9), pp.1558-1568.
Neumann, W.J., Steiner, L.A. and Milosevic, L., 2023. Neurophysiological mechanisms of deep brain stimulation across spatiotemporal resolutions. Brain, 146(11), pp.4456-4468.
To cite this abstract in AMA style:
H. Ding, K. Xie, B. Bahners, W. He, J. Chen, M. Metzger, B. Nasseroleslami, J. Volkmann, D. Li, M. Muthuraman, C. Zhang. Distinct Local and Global Functional Network Reorganization Underlying STN versus GPi DBS in Parkinson’s Disease [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/distinct-local-and-global-functional-network-reorganization-underlying-stn-versus-gpi-dbs-in-parkinsons-disease/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/distinct-local-and-global-functional-network-reorganization-underlying-stn-versus-gpi-dbs-in-parkinsons-disease/