A Comprehensive Review of Brain Connectomics and Imaging to Improve Deep Brain Stimulation Outcomes

Joshua K. Wong, Erik H. Middlebrooks, Sanjeet S. Grewal, Leonardo Almeida, Christopher W. Hess, Michael S. Okun

Research output: Contribution to journalReview articlepeer-review

34 Scopus citations

Abstract

DBS is an effective neuromodulatory therapy that has been applied in various conditions, including PD, essential tremor, dystonia, Tourette syndrome, and other movement disorders. There have also been recent examples of applications in epilepsy, chronic pain, and neuropsychiatric conditions. Innovations in neuroimaging technology have been driving connectomics, an emerging whole-brain network approach to neuroscience. Two rising techniques are functional connectivity profiling and structural connectivity profiling. Functional connectivity profiling explores the operational relationships between multiple regions of the brain with respect to time and stimuli. Structural connectivity profiling approximates physical connections between different brain regions through reconstruction of axonal fibers. Through these techniques, complex relationships can be described in various disease states, such as PD, as well as in response to therapy, such as DBS. These advances have expanded our understanding of human brain function and have provided a partial in vivo glimpse into the underlying brain circuits underpinning movement and other disorders. This comprehensive review will highlight the contemporary concepts in brain connectivity as applied to DBS, as well as introduce emerging considerations in movement disorders.

Original languageEnglish (US)
Pages (from-to)741-751
Number of pages11
JournalMovement Disorders
Volume35
Issue number5
DOIs
StatePublished - May 1 2020
Externally publishedYes

Bibliographical note

Funding Information:
J.K.W.'s DBS research is supported by R25 NS108939. C.W.H. has served as a site investigator or coinvestigator for research projects funded by the Parkinson's Foundation and has served as a research committee member for the Michael J. Fox Foundation. C.W.H. has served as a speaker for the National Parkinson Foundation, the Parkinson's Disease Foundation, and the Davis Phinney Foundation. C.W.H. has participated in CME and educational activities on movement disorders sponsored by Allergan, Ipsen, Mertz Pharmaceuticals, Peerview Online, UptoDate, and QuantiaMD. E.H.M. has received research support from Varian Medical Systems, Inc. and Boston Scientific. L.A. serves as a consultant for and has received honoraria from Medtronic and Boston Scientific. M.S.O. serves as a consultant for the Parkinson's Foundation and has received research grants from the NIH, Parkinson's Foundation, the Michael J. Fox Foundation, the Parkinson Alliance, Smallwood Foundation, the Bachmann‐Strauss Foundation, the Tourette Syndrome Association, and the UF Foundation. M.S.O.'s DBS research is supported by: R01 NR014852 and R01NS096008. M.S.O. has received royalties for publications with Demos, Manson, Amazon, Smashwords, Books4Patients, Perseus, Robert Rose, Oxford, and Cambridge (movement disorders books). M.S.O. is an associate editor for . M.S.O. has participated in CME and educational activities on movement disorders sponsored by the Academy for Healthcare Learning, PeerView, Prime, QuantiaMD, WebMD/Medscape, Medicus, MedNet, Einstein, MedNet, Henry Stewart, American Academy of Neurology, International and Parkinson and Movement Disorder Society, and by Vanderbilt University. The institution and not M.S.O. receives grants from Medtronic, AbbVie, Abbott, and Allergan, and the principal investigator (PI) has no financial interest in these grants. M.S.O. has participated as a site PI and/or coinvestigator for several NIH‐, foundation‐, and industry‐sponsored trials over the years, but has not received honoraria. Research projects at the University of Florida receive device and drug donations. New England Journal of Medicine Journal Watch Neurology

Publisher Copyright:
© 2020 International Parkinson and Movement Disorder Society

Keywords

  • connectivity profile
  • connectomics
  • deep brain stimulation
  • functional connectivity
  • structural connectivity

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