[Retracted] Measuring Subthalamic Nucleus Volume of Parkinson’s Patients and Evaluating Its Relationship with Clinical Scales at Pre‐ and Postdeep Brain Stimulation Treatment: A Magnetic Resonance Imaging Study

Abstract

This study investigated potential imaging biomarkers for predicting the efficacy of deep brain stimulation (DBS) of the subthalamic nucleus (STN) in patients with Parkinson’s disease (PD). A total of 59 PD patients and 50 healthy control subjects underwent high-resolution 3-dimensional T1-weighted brain magnetic resonance imaging. Bilateral STN volumes were compared between the 2 groups, and a correlation analysis was performed to assess the relationship between bilateral STN volumes or intracranial volume (ICV) and pre- or postoperative clinical scale scores. The results showed that the left STN volume differed significantly between PD patients and controls. In patients, the left STN volume was negatively correlated with pre- and postoperative quality of life scores and positively correlated with Mini-mental State Examination (MMSE) and Montreal Cognitive Assessment scores; ICV was also positively correlated with the MMSE score. These findings indicate that changes in the left STN volume are a useful biomarker for evaluating the clinical outcome of PD patients following DBS.

A systematic review of brain morphometry related to deep brain stimulation outcome in Parkinson’s disease

“… 6 mo Med off: 52.2 ± 13.4 NR Yim; 2020 23 81 (40/41) STN 9.95 ± 4.6 59.0 ± 8.9 ↑ Volumes of the anterior cingulate and right thalamus in the higher motor improvement (MI) group. 1 yr Med off:50.1 ± 14.0; Med on:14.7 ± 9.8 Med off: Higher MI group:4.2 ± 3.6; Lower MI group:26.6 ± 16.9 Lu; 2021 22 59 (33/26) 57 BL STN 2 BL GPi 8.2 ± 4.3 PD:65.7 ± 7:5; Control:59.8 ± 7.1 The left or right STN volume and ICV did not correlate with pre- and post- UPDRSIII scores. 6 mo NR NR Chen; 2022 10 Training set: 73 (45/28); Test set: 21 (11/10) BL STN Training set:8.0 [5.9, 11.0]; Test set: 8.0[6.0, 11.9] Training set :63.0 [57.0,68.3]; Test set:63.0 [57.0,68.3] ↑ Cortical thickness of the right precentral cortex & Increased percent improvement in MDS-UPDRSIII med off/med off, stim on .…”

“… / Nondelirium: 50.2 ± 13.6; Delirium: 55.9 ± 14.6 NR Radziunas; 2020 36 22 (10/12) BL STN; 18 healthy controls Pts without neuropsychiatric complications: 10.4 ± 4.0; Pts with neuropsychiatric complications: 13.5 ± 2.5 58.0 ± 8.2 ↓ White matter volume, cortical thickness and cortical area of the left caudal middle frontal area & Increased incidence of neuropsychiatric complications. / Med on: 17.4 ± 6.1 NR Lu; 2021 22 59 (33/26) 57 BL STN 2 BL GPi 8.2 ± 4.3 PD:65.7 ± 7.5; Control: 59.8 ± 7.1 ↓ The left and right STN volume & Increased postoperative HAMD score. 6 mo NR NR PDpD PD patients with postsurgical dementia, PDnpD PD patients without postsurgical dementia, POD = postoperative delirium, STN subthalamic nucleus, GPi internal globus pallidus, VIN ventral intermediate nucleus, NBM nucleus of basalis of Meynert, BL bilateral, UL unilateral, WML white matter lesions, ICV intracranial volume, UPDRS Unified Parkinson’s Disease Rating Scale, CVLT-II The California verbal learning test-II, HAMD Hamilton Depression Scale, MMSE Mini Mental Status Examination, MDRS Mattis Dementia Rating Scale, MOCA Montreal Cognitive Assessment, pts patients, yr year(s), mo month(s), d day(s), NR not recorded, ↑ increased, ↓ decreased; − = no correlation, med on = medication on, med off = medication off, stim on = stimulation on, stim off = stimulation off.…”

“…Two studies used the ratio of UPDRSIII med off/ med off, stim on 11 , 14 . Two study using the absolute postsurgical UPDRSIII med off, stim on score 21 , 22 . One study used percent improvement in postoperative UPDRSIII (UPDRSIII med off, stim off / med off, stim on ) 23 .…”

“…↑ Volume of the right hippocampus volume & Improvement in CVLT-II recognition hits score. 14.4 ± 6.4 mo NR Percent change in UPDRS score: −36.8 (± 27.4) Lu; 2021 22 59 (33/26) 57 BL STN 2 BL GPi 8.2 ± 4.3 PD:65.7 ± 7.5; Control: 59.8 ± 7.1 ↑ The left STN volume & Higher preoperative MMSE and MoCA scores. 6 mo NR NR Kübler; 2022 33 55 (39/16) BL STN 10.8 ± 4.7 61.4 ± 7.5 ↑ NBM volume & Improved cognitive outcome measured by MMSE or DemTect score.…”

“…Eight studies that were included in our review reported associations of brain volumetry with the cognitive outcome 15 , 22 , 28 – 33 . ROI analysis assessing specific structures was adopted in these studies.…”