Nature communications · 2022
Optimal deep brain stimulation sites and networks for stimulation of the fornix in Alzheimer's disease.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Ríos Ana Sofía, Oxenford Simón, Neudorfer Clemens, Butenko Konstantin, Li Ningfei, Rajamani Nanditha, Boutet Alexandre, Elias Gavin J B, Germann Jurgen, Loh Aaron, Deeb Wissam, Wang Fuyixue, Setsompop Kawin, Salvato Bryan, Almeida Leonardo Brito de, Foote Kelly D, Amaral Robert, Rosenberg Paul B, Tang-Wai David F, Wolk David A, Burke Anna D, Salloway Stephen, Sabbagh Marwan N, Chakravarty M Mallar, Smith Gwenn S, Lyketsos Constantine G, Okun Michael S, Anderson William S, Mari Zoltan, Ponce Francisco A, Lozano Andres M, Horn Andreas
Аннотация
Deep brain stimulation (DBS) to the fornix is an investigational treatment for patients with mild Alzheimer's Disease. Outcomes from randomized clinical trials have shown that cognitive function improved in some patients but deteriorated in others. This could be explained by variance in electrode placement leading to differential engagement of neural circuits. To investigate this, we performed a post-hoc analysis on a multi-center cohort of 46 patients with DBS to the fornix (NCT00658125, NCT01608061). Using normative structural and functional connectivity data, we found that stimulation of the circuit of Papez and stria terminalis robustly associated with cognitive improvement (R = 0.53, p < 0.001). On a local level, the optimal stimulation site resided at the direct interface between these structures (R = 0.48, p < 0.001). Finally, modulating specific distributed brain networks related to memory accounted for optimal outcomes (R = 0.48, p < 0.001). Findings were robust to multiple cross-validation designs and may define an optimal network target that could refine DBS surgery and programming.