Optimal deep brain stimulation sites pathways and networks for different Symptoms in Dystonia

Motivation: STN-targeted DBS shows promise in Dystonia treatment. However, optimal stimulation sites, pathway modulation, and network effects for different dystonia subtypes are unknown. Goal(s): To examine stimulation sites, pathway modulation, and network effects in dystonia subtypes for personalized DBS interventions. Approach: Retrospective study of 71 dystonia patients undergoing STN-DBS. Clinical outcomes assessed with Burke-Fahn-Marsden Dystonia Rating Scale. Imaging, tissue activation estimation, and pathway/network reconstruction performed using Lead-DBS and Iso2Mesh toolbox. Results: Subtypes have varied stimulation sites. Orofacial group shows positive correlations between VTA-STN intersection and clinical improvement. Dorsolateral STN effective for orofacial and hindlimb symptoms. Targeting lenticular fasciculus benefits orofacial dystonia. Impact: Study proposes a comprehensive model for personalized DBS, improving treatment strategies. Further research needed to validate targets, pathways, and networks, enhancing clinical decision-making and outcomes.