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Investigation of the metabolic networks responsible for the clinical outcome of deep brain stimulation using dynamic FDG-fPET

Description

For most people with PD, non-motor symptoms are far more disabling than motor symptoms. These include neuropsychiatric symptoms such as depression and dementia, loss of sense of smell, sleep disturbances, gastrointestinal symptoms such as constipation, and various autonomic nervous system disorders. The non-motor symptoms dominate the clinical picture of advanced PD and often lead to a drastic deterioration in quality of life. Deep brain stimulation (DBS) is a well-established neurosurgical treatment for the management of motor symptoms in advanced PD. Studies by Dafsari et al in 2015 showed that DBS also has a beneficial effect on non-motor symptoms of PD. However, the neurophysiological basis for the success of THS remains unclear. Previous studies concluded that the clinical success of THS correlates with a specific pattern of structural and functional connectivity of the stimulated brain area. These findings laid the groundwork for using preoperative functional connectivity profiles as an indicator of THS success. However, functional connectivity based on fMRI data is a very indirect measure of neural activity. In contrast, a more direct measure of neural activity is metabolic connectivity, which can be visualised by 18F-fluorodeoxyglucose (FDG) positron emission tomography studies and provides information about metabolic networks. Therefore, this work will use preoperatively acquired dynamic fPET data to perform metabolic connectivity analyses at the individual patient level, revealing those connections that are crucial for the outcome of THS in relation to non-motor symptoms of PD. If metabolic networks defined in this way are found to correlate with the outcome of THS, it would be possible in the future to predict the clinical outcome of THS for each individual patient, especially with regard to the improvement of non-motor symptoms, and to optimise the use of stimulation electrodes accordingly.

Contact

Dr. Marina Rupper-Junck and Dr. Philipp Löhrer
Mrs. Maya Beckersjürgen
Telefone: 06421/58 - 65299
Telefax: 06421/58 - 67055
marina.ruppert@

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