Optimal deep brain stimulation sites and networks for stimulation of the fornix in Alzheimer's disease.
Journal
Nature communications
ISSN: 2041-1723
Titre abrégé: Nat Commun
Pays: England
ID NLM: 101528555
Informations de publication
Date de publication:
14 12 2022
14 12 2022
Historique:
received:
05
11
2021
accepted:
27
10
2022
entrez:
14
12
2022
pubmed:
15
12
2022
medline:
17
12
2022
Statut:
epublish
Résumé
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.
Identifiants
pubmed: 36517479
doi: 10.1038/s41467-022-34510-3
pii: 10.1038/s41467-022-34510-3
pmc: PMC9751139
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
7707Subventions
Organisme : NIA NIH HHS
ID : P30 AG072979
Pays : United States
Organisme : NIMH NIH HHS
ID : R01 MH130666
Pays : United States
Informations de copyright
© 2022. The Author(s).
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