Evaluating a Motor Progression Connectivity Model Across Parkinson’s Disease Stages

ABSTRACT Background Stimulation of a specific site in the dorsolateral subthalamic nucleus (STN) was recently associated with slower motor progression in Parkinson’s Disease (PD), based on the deep brain stimulation (DBS) in early-stage PD pilot trial. Objective To test whether stimulation of this site is associated with improvements of long-term motor outcomes in advanced-stage PD. Methods Active contacts of the early DBS cohort (N=14) were analyzed. Sweet spot and connectivity models derived from this cohort were then used to estimate long-term motor outcomes in an independent DBS cohort of advanced-stage PD patients (N=29). Results In early-stage PD, proximity of stimulation to the dorsolateral STN associated with slower motor progression. In advanced-stage PD, stimulation proximity to the same site associated with better long-term motor outcomes (R=0.60, P<0.001). Conclusions Results: suggest stimulation of a specific site in the dorsolateral STN associates with both slower motor progression and long-term motor improvements in PD.