Subthalamic nucleus deep brain stimulation for cranial-cervical dystonia: optimal stimulation sites and networks
Background and objectives: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an effective treatment for medically refractory cranial-cervical dystonia (CCD or Meige syndrome). However, clinical responses vary substantially across individuals, likely due to differences in electrode pla...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-09-01
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| Series: | Brain Stimulation |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1935861X25002979 |
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| author | Hutao Xie Jiansong Huang Ningfei Li Houyou Fan Shihang Yang Zixiao Yin Zhaoting Zheng Zehua Zhao Yin Jiang Lin Shi Anchao Yang Fangang Meng Guanyu Zhu Quan Zhang Jianguo Zhang |
| author_facet | Hutao Xie Jiansong Huang Ningfei Li Houyou Fan Shihang Yang Zixiao Yin Zhaoting Zheng Zehua Zhao Yin Jiang Lin Shi Anchao Yang Fangang Meng Guanyu Zhu Quan Zhang Jianguo Zhang |
| author_sort | Hutao Xie |
| collection | DOAJ |
| description | Background and objectives: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an effective treatment for medically refractory cranial-cervical dystonia (CCD or Meige syndrome). However, clinical responses vary substantially across individuals, likely due to differences in electrode placement and modulation of target neural circuits. Methods: We retrospectively analyzed 51 patients with CCD treated with STN-DBS at a single center. Pre- and postoperative imaging was used to reconstruct electrode locations and model patient-specific electric fields. We then performed (i) voxel-wise sweet spot mapping to identify optimal stimulation sites, (ii) fiber filtering using normative tractography to determine white matter pathways associated with clinical improvement, and (iii) network mapping based on resting-state fMRI to identify functional connectivity patterns predictive of DBS response. Results: Voxel-wise correlation analysis revealed that the optimal stimulation localized to the STN motor subregion (R = 0.52, p < 0.001). Normative structural connectivity analysis showed that symptom improvement correlated strongly with modulation of fibers projecting to the cranial and cervical regions of sensorimotor cortex (R = 0.52, p < 0.001) and sensorimotor-associated basal ganglia pathways (R = 0.62, p < 0.001). Functional network mapping further revealed connectivity to the sensorimotor cortex as significantly associated with clinical improvement (R = 0.43, p = 0.002). Conclusion: These findings inform refinement of STN targeting strategies in DBS for CCD. The involvement of cranial and cervical sensorimotor regions highlights the importance of symptom-based dystonia classification for individualized neuromodulation approaches. |
| format | Article |
| id | doaj-art-6783661d1376442e942e8141963b40e9 |
| institution | Kabale University |
| issn | 1935-861X |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brain Stimulation |
| spelling | doaj-art-6783661d1376442e942e8141963b40e92025-08-20T05:06:18ZengElsevierBrain Stimulation1935-861X2025-09-011851539155010.1016/j.brs.2025.08.003Subthalamic nucleus deep brain stimulation for cranial-cervical dystonia: optimal stimulation sites and networksHutao Xie0Jiansong Huang1Ningfei Li2Houyou Fan3Shihang Yang4Zixiao Yin5Zhaoting Zheng6Zehua Zhao7Yin Jiang8Lin Shi9Anchao Yang10Fangang Meng11Guanyu Zhu12Quan Zhang13Jianguo Zhang14Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaMovement Disorders and Neuromodulation Unit, Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, GermanyDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaSchool of Electronics Engineering and Computer Science, Peking University, Beijing, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neurostimulation, Beijing, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Corresponding author. The South Fourth Ring Road, West Road, Fengtai District & No. 119, Beijing, 100070, China.Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Corresponding author. The South Fourth Ring Road, West Road, Fengtai District & No. 119, Beijing, 100070, China.Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neurostimulation, Beijing, China; Corresponding author. The South Fourth Ring Road, West Road, Fengtai District & No. 119, Beijing, 100070, China.Background and objectives: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an effective treatment for medically refractory cranial-cervical dystonia (CCD or Meige syndrome). However, clinical responses vary substantially across individuals, likely due to differences in electrode placement and modulation of target neural circuits. Methods: We retrospectively analyzed 51 patients with CCD treated with STN-DBS at a single center. Pre- and postoperative imaging was used to reconstruct electrode locations and model patient-specific electric fields. We then performed (i) voxel-wise sweet spot mapping to identify optimal stimulation sites, (ii) fiber filtering using normative tractography to determine white matter pathways associated with clinical improvement, and (iii) network mapping based on resting-state fMRI to identify functional connectivity patterns predictive of DBS response. Results: Voxel-wise correlation analysis revealed that the optimal stimulation localized to the STN motor subregion (R = 0.52, p < 0.001). Normative structural connectivity analysis showed that symptom improvement correlated strongly with modulation of fibers projecting to the cranial and cervical regions of sensorimotor cortex (R = 0.52, p < 0.001) and sensorimotor-associated basal ganglia pathways (R = 0.62, p < 0.001). Functional network mapping further revealed connectivity to the sensorimotor cortex as significantly associated with clinical improvement (R = 0.43, p = 0.002). Conclusion: These findings inform refinement of STN targeting strategies in DBS for CCD. The involvement of cranial and cervical sensorimotor regions highlights the importance of symptom-based dystonia classification for individualized neuromodulation approaches.http://www.sciencedirect.com/science/article/pii/S1935861X25002979Cranial-cervical dystoniaMeige syndromeDeep brain stimulationSubthalamic nucleusConnectome |
| spellingShingle | Hutao Xie Jiansong Huang Ningfei Li Houyou Fan Shihang Yang Zixiao Yin Zhaoting Zheng Zehua Zhao Yin Jiang Lin Shi Anchao Yang Fangang Meng Guanyu Zhu Quan Zhang Jianguo Zhang Subthalamic nucleus deep brain stimulation for cranial-cervical dystonia: optimal stimulation sites and networks Brain Stimulation Cranial-cervical dystonia Meige syndrome Deep brain stimulation Subthalamic nucleus Connectome |
| title | Subthalamic nucleus deep brain stimulation for cranial-cervical dystonia: optimal stimulation sites and networks |
| title_full | Subthalamic nucleus deep brain stimulation for cranial-cervical dystonia: optimal stimulation sites and networks |
| title_fullStr | Subthalamic nucleus deep brain stimulation for cranial-cervical dystonia: optimal stimulation sites and networks |
| title_full_unstemmed | Subthalamic nucleus deep brain stimulation for cranial-cervical dystonia: optimal stimulation sites and networks |
| title_short | Subthalamic nucleus deep brain stimulation for cranial-cervical dystonia: optimal stimulation sites and networks |
| title_sort | subthalamic nucleus deep brain stimulation for cranial cervical dystonia optimal stimulation sites and networks |
| topic | Cranial-cervical dystonia Meige syndrome Deep brain stimulation Subthalamic nucleus Connectome |
| url | http://www.sciencedirect.com/science/article/pii/S1935861X25002979 |
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