Pre-Stimulation Resting-State Connectivity at Dentate Nucleus Stimulation Contacts is Associated with Subsequent Motor Recovery Post-Stroke

Motivation: Dentate nucleus (DN) deep brain stimulation (DBS) can enhance motor recovery in chronic post-stroke participants, however current procedures for choosing contacts to activate requires time-consuming task-based evaluations. Goal(s): To determine if pre-stimulation resting-state functional MRI (rsfMRI) connectivity of the brain at active contacts is associated with subsequent motor recovery. Approach: Using each active contact location as a seed, z-maps were calculated from the pre-stimulation rsfMRI. If significant clusters were found in cortex, the contact was classified as FCcortical, otherwise it was classified as FCnon-cortical. Results: The median motor recovery associated with active FCcortical contacts was significantly higher by 2.5-fold compared to FCnon-cortical contacts. Impact: Our results show that pre-stimulation rsfMRI connectivity of the brain at active contacts is associated with subsequent motor recovery, supporting its use to streamline the identification of optimal contacts to activate for DN-DBS therapy to enhance post-stroke motor recovery.