Subthalamic stimulation shifts brain network dynamics from extensive functional support to motor dominance in Parkinson’s disease

Therapeutic deep brain stimulation (DBS) rebalances local motor circuitry activity in Parkinson's disease (PD). However, the mechanistic understanding of how DBS impacts global macroscale dynamic functional network states remains limited, particularly regarding its effects on motor and non-motor networks. To address this, we employed an algorithm for dynamic functional connectivity co-activation patterns (DFCCAP) based on fMRI data to identify intrinsic macroscale neural states in the brain of healthy elderly individuals. Furthermore, by conducting a statistical analysis of the spatiotemporal properties of these patterns under different acquisition parameters and regional parcellation resolutions, we demonstrated the reproducibility of the results. Building on this, we examined 27 PD patients to investigate abnormalities in these dynamic macroscale state patterns and explored the modulatory effects of subthalamic stimulation. Our findings revealed that DBS induces selective activation and inhibition of macroscale states within specific functional networks across the whole brain. These states were characterized by four distinct classes of dynamic functional connectivity co-activation patterns. Subthalamic stimulation modulated abnormal dynamic features in PD, facilitating a shift from extensive functional brain network engagement to motor network dominance. This study provides novel insights into the intrinsic mechanisms underlying brain dynamics modulated by subthalamic stimulation. These findings illuminate how motor function recovery is supported while highlighting potential trade-offs in non-motor functional networks. This research enhances our understanding of brain network dynamics in PD, providing a foundation for refining therapeutic strategies and exploring innovative approaches to treating brain disorders.