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Research ArticleNEUROIMAGING PHYSICS/FUNCTIONAL NEUROIMAGING/CT AND MRI TECHNOLOGY

Individual Structural Covariance Network Predicts Long-Term Motor Improvement in Parkinson Disease with Subthalamic Nucleus Deep Brain Stimulation

Yu Diao, Hutao Xie, Yanwen Wang, Baotian Zhao, Anchao Yang and Jianguo Zhang
American Journal of Neuroradiology June 2024, DOI: https://doi.org/10.3174/ajnr.A8245
Yu Diao
aFrom the Department of Neurosurgery (Y.D., H.X., Y.W., B.Z., A.Y., J.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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  • ORCID record for Yu Diao
Hutao Xie
aFrom the Department of Neurosurgery (Y.D., H.X., Y.W., B.Z., A.Y., J.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Yanwen Wang
aFrom the Department of Neurosurgery (Y.D., H.X., Y.W., B.Z., A.Y., J.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Baotian Zhao
aFrom the Department of Neurosurgery (Y.D., H.X., Y.W., B.Z., A.Y., J.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Anchao Yang
aFrom the Department of Neurosurgery (Y.D., H.X., Y.W., B.Z., A.Y., J.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
bBeijing Key Laboratory of Neurostimulation (A.Y., J.Z.), Beijing, China
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Jianguo Zhang
aFrom the Department of Neurosurgery (Y.D., H.X., Y.W., B.Z., A.Y., J.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
bBeijing Key Laboratory of Neurostimulation (A.Y., J.Z.), Beijing, China
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  • FIG 1.
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    FIG 1.

    Schematic outline of the study. A, Gray matter volumes were computed by using the CAT12 toolbox, and gray matter volumes were extracted based on the AAL3 atlas for all HC and patients with PD. B, Individual structural covariance network computation process for patients. PCC indicates Pearson correlation coefficient.

  • FIG 2.
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    FIG 2.

    Clinical Improvement: A, Differences in preoperative and long-term postoperative scores for motor and nonmotor scales in patients with DBS improvement rates in the GIG and MIG. Paired t-tests were conducted for data that passed the normality test, while the Wilcoxon signed-rank test was used for data that did not meet the normality assumption. B, Comparison of the improvement rates in motor and nonmotor symptoms between the GIG and MIG. For normally distributed data, a two-sample t test was employed, whereas the Wilcoxon rank-sum test was used for data that did not meet the normality assumption.

  • FIG 3.
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    FIG 3.

    Intergroup differences in edges and prediction, A, Comparison of intergroup differences in edges between the GIG (blue) and MIG (red) patient groups for edges that are correlated with DBS improvement rate and ranked in the top 1%. Age, sex, TIV, and MoCA were included as covariates. After FDR correction, significant intergroup differences are found in all 6 edges. B, Prediction of long-term improvement groups in patients using 6 edge features.

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    FIG 4.

    The relationship between graph theory metrics and long-term treatment outcomes. Red spherical nodes represent brain regions with P-values corrected for false discovery rate below .05. A, Degree centrality of nodes that correlated with long-term motor prognosis. B, Local efficiency of nodes that correlated with long-term motor prognosis.

  • FIG 5.
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    FIG 5.

    Individual structural covariance networks for predicting long-term treatment outcomes. A, Six edges of correlations with DBS improvement rates, with age, sex, and TIV as covariates. B, Weights of the 6 edges in predicting long-term DBS improvement rates by using the XGBoost model. C, Correlation between the actual and predicted values of long-term DBS improvement rates for the 6 edges by using the XGBoost model.

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    Table 1:

    Baseline and follow-up

    Preoperative Mean±SD (range)Postoperative Mean±SD (range)P
    Sex (M/F)73/6573/65–
    Age (years)62.08 ± 8.52 (35–82)62.08 ± 8.52 (35–82)–
    Durations (years)11.72 ± 4.73 (5–29)11.72 ± 4.73 (5–29)–
    LEDD (mg)773.37 ± 351.27 (0–1735.65)555.66 ± 291.21 (0–1580)<.001
    MDS-UPDRS-III (med off)49.86 ± 16.00 (18–97)24.61 ± 13.49 (3–65)<.001
    MDS-UPDRS-III-tremor (med off)10.95 ± 7.68 (0–33)3.33 ± 4.35 (0–22)<.001
    MDS-UPDRS-III-rigidity (med off)8.78 ± 3.67 (2–23)2.75 ± 2.92 (0–12)<.001
    FOGQ11.58 ± 8.22 (0–24)7.54 ± 7.47 (0–24)<.001
    Berg37.62 ± 13.36 (1–56)45.84 ± 10.21 (2–56)<.001
    MoCA21.82 ± 4.22 (10–30)21.90 ± 4.39 (10–30).564
    HAMA18.41 ± 9.53 (2–51)12.31 ± 8.57 (0–44)<.001
    HAMD18.25 ± 9.18 (1–58)13.85 ± 10.15 (0–55)<.001
    • Note:—Outcome changes from baseline to follow-up of each group were tested by using Wilcoxon signed-rank tests. LEDD indicates levodopa equivalent dose.

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Yu Diao, Hutao Xie, Yanwen Wang, Baotian Zhao, Anchao Yang, Jianguo Zhang
Individual Structural Covariance Network Predicts Long-Term Motor Improvement in Parkinson Disease with Subthalamic Nucleus Deep Brain Stimulation
American Journal of Neuroradiology Jun 2024, DOI: 10.3174/ajnr.A8245

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Individual Structural Covariance Network Predicts Long-Term Motor Improvement in Parkinson Disease with Subthalamic Nucleus Deep Brain Stimulation
Yu Diao, Hutao Xie, Yanwen Wang, Baotian Zhao, Anchao Yang, Jianguo Zhang
American Journal of Neuroradiology Jun 2024, DOI: 10.3174/ajnr.A8245
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