Comparing Functional and Anatomical Division of the Subthalamic Nucleus as a Predictor of Clinical Outcomes in Deep Brain Stimulation
Author:
Deana Marchuk ’28Co-Authors:
Faculty Mentor(s):
Karlo Malaga, Biomedical EngineeringFunding Source:
Gary & Sandy Sojka Fund for Research, Teaching & Scholarship in Developmental Disabilities, Neuroscience & Human HealthAbstract
The subthalamic nucleus (STN) is one of the most common targets for deep brain stimulation (DBS), a treatment for alleviating the motor symptoms of Parkinson disease (PD). DBS involves implanting electrodes into the STN to deliver electrical stimulation, with the goal of reducing motor symptoms and improving quality of life for patients with PD. However, its success strongly depends on where within the STN the stimulation occurs. This study aims to determine which segmentation method more closely correlates with motor symptom improvement in DBS.
40 PD patients who previously underwent bilateral STN DBS were included for analysis. Outcomes were measured as percentage improvement across rigidity, tremor, bradykinesia, and overall motor symptom. Anatomical segmentation was performed by dividing each STN into six regions using its center of mass as a reference point. Functional segmentation was derived using the Accolla atlas, which labels the STN into motor, associative, and limbic zones. The atlas was registered to each STN and then the volume of tissue activation relative to the total volume of the STN was calculated to quantify stimulation.
Results showed that functional motor zone activation weakly correlated with rigidity improvement, while other functional zones showed no significant associations. In contrast, anatomical dorsal STN stimulation significantly correlated with rigidity and distinguished responder groups. The dorsal anatomical region demonstrated stronger clinical relevance.