Utility of diffusion tensor imaging and generalized q-sampling imaging for predicting short-term clinical effect of deep brain stimulation in Parkinson’s disease

Category	Detail
Condition	Parkinson’s disease (PD), a progressive neurodegenerative disorder characterized by motor and non-motor symptoms due to dopaminergic neuron loss
Key Mechanisms	Loss of dopaminergic neurons in substantia nigra and Lewy body accumulation causing motor pathway dysregulation; DBS modulates neural pathways via electrical stimulation of subthalamic nucleus
Target Population	Patients with clinically idiopathic Parkinson’s disease undergoing deep brain stimulation surgery
Care Setting	Neurological surgical centers performing DBS with preoperative MRI imaging and postoperative clinical follow-up

DTI and GQI are advanced MRI techniques assessing brain microstructural integrity, potentially predicting DBS outcomes preoperatively
DBS targeting the subthalamic nucleus improves motor symptoms and may reduce medication needs in PD
This study retrospectively evaluates whether preoperative DTI and GQI parameters correlate with 3-month postoperative clinical outcomes

Use clinical criteria for idiopathic PD diagnosis
Employ MRI including DTI and GQI sequences preoperatively for microstructural brain assessment

Consider DBS targeting the subthalamic nucleus for motor symptom control in PD
Utilize stereotactic planning with fused MRI and CT imaging for accurate electrode placement
Use directional leads and intraoperative microelectrode recording and macrostimulation to optimize DBS implantation

Assess clinical outcomes post-DBS using Unified Parkinson’s Disease Rating Scale (UPDRS) and Parkinson’s Disease Questionnaire-39 (PDQ-39)
Perform 3-month postoperative follow-up evaluations to monitor treatment efficacy

Exclude patients with prior cranial surgery, brain neoplasms, or incomplete follow-up to reduce confounding factors
Monitor for potential complications related to DBS surgery and MRI procedures

Adults over 18 years with idiopathic PD undergoing DBS surgery

Preoperative DTI and GQI imaging may help predict short-term clinical response to DBS, aiding patient selection and management

Perform high-resolution 3.0 Tesla MRI with DTI and GQI sequences 1–3 days before DBS surgery
Fuse MRI with CT imaging for precise stereotactic targeting of the subthalamic nucleus
Use standardized clinical scales (UPDRS, PDQ-39) for pre- and post-operative assessment
Apply directional leads and intraoperative neurophysiological monitoring to optimize electrode placement
Ensure thorough patient selection excluding those with prior cranial interventions or incomplete follow-up

Clinical Scorecard: Evaluating the Role of Diffusion Tensor Imaging and Generalized Q-Sampling Imaging in Forecasting Short-Term Outcomes of Deep Brain Stimulation for Parkinson’s Disease