fMRI during active GPi DBS uncovers target-specific networks
6 affiliations
- 1Division of Neurosurgery, Department of Surgery, University of Toronto
- 2GE HealthCare Technology & Innovation Center, Niskayuna
- 3Edmond J. Safra Program in Parkinson’s Disease and Morton and Gloria Shulman Movement Disorders Centre, Toronto Western Hospital, UHN
- 4Department of Clinical Neurological Sciences, Western University
- 5University Health Network, University of Toronto
- 6Krembil Brain Institute
Abstract
Improved understanding of target-specific changes in brain activity during deep-brain stimulation (DBS) for Parkinson’s disease (PD) may refine target selection. Here, we study the network effects of active DBS using functional magnetic resonance imaging (fMRI) during stimulation of the subthalamic nucleus (STN) and globus pallidus internus (GPi). About 36 PD patients (62.5 ± 8.1 years, 18 GPi-DBS, 39% female) underwent prospective fMRI during active DBS. DBS produced distributed cortical modulation associated with clinical improvement at the group level. Network modeling revealed symptom-specific coupling, with somatomotor network modulation significantly associated with gait improvement (ΔR² = 0.40, p FDR = 0.03) and showing a weaker association with bradykinesia improvement (ΔR² = 0.32, p FDR = 0.06). Unexpectedly, somatomotor network modulation showed a nominal association with variability in verbal fluency outcomes (ΔR² = 0.28, p FDR = 0.08), whereas language and cognitive networks demonstrated minimal explanatory value. A comparable relationship between network modulation and verbal fluency was not observed in STN-DBS. These findings demonstrate that DBS therapeutic effects are best understood as modulation of distributed functional networks rather than focal regions, with target-dependent network coupling potentially underlying differential cognitive outcomes.
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BibTeX
@article{santyr2026fmri,
title = {{fMRI during active GPi DBS uncovers target-specific networks}},
author = {Brendan Santyr and Clement Chow and Jürgen Germann and Alexandre Boutet and Afis Ajala and Jianwei Qiu and Arron Loh and Ibrahim Alhashyan and Mohamad Abbass and Gavin Elias and Can Sarica and Artur Vetkas and Andrew Yang and Desmond Yeo and Suneil Kalia and Melanie Cohn and Alfonso Fasano and Andres M. Lozano},
journal = {npj Parkinson's Disease},
year = {2026},
month = jul,
doi = {10.1038/s41531-026-01476-8},
url = {https://doi.org/10.1038/s41531-026-01476-8},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - fMRI during active GPi DBS uncovers target-specific networks
AU - Brendan Santyr
AU - Clement Chow
AU - Jürgen Germann
AU - Alexandre Boutet
AU - Afis Ajala
AU - Jianwei Qiu
AU - Arron Loh
AU - Ibrahim Alhashyan
AU - Mohamad Abbass
AU - Gavin Elias
AU - Can Sarica
AU - Artur Vetkas
AU - Andrew Yang
AU - Desmond Yeo
AU - Suneil Kalia
AU - Melanie Cohn
AU - Alfonso Fasano
AU - Andres M. Lozano
PY - 2026
DA - 2026/07/01
JO - npj Parkinson's Disease
DO - 10.1038/s41531-026-01476-8
UR - https://doi.org/10.1038/s41531-026-01476-8
AB - Improved understanding of target-specific changes in brain activity during deep-brain stimulation (DBS) for Parkinson’s disease (PD) may refine target selection. Here, we study the network effects of active DBS using functional magnetic resonance imaging (fMRI) during stimulation of the subthalamic nucleus (STN) and globus pallidus internus (GPi). About 36 PD patients (62.5 ± 8.1 years, 18 GPi-DBS, 39% female) underwent prospective fMRI during active DBS. DBS produced distributed cortical modulation associated with clinical improvement at the group level. Network modeling revealed symptom-specific coupling, with somatomotor network modulation significantly associated with gait improvement (ΔR² = 0.40, p FDR = 0.03) and showing a weaker association with bradykinesia improvement (ΔR² = 0.32, p FDR = 0.06). Unexpectedly, somatomotor network modulation showed a nominal association with variability in verbal fluency outcomes (ΔR² = 0.28, p FDR = 0.08), whereas language and cognitive networks demonstrated minimal explanatory value. A comparable relationship between network modulation and verbal fluency was not observed in STN-DBS. These findings demonstrate that DBS therapeutic effects are best understood as modulation of distributed functional networks rather than focal regions, with target-dependent network coupling potentially underlying differential cognitive outcomes.
SN - 2373-8057
ER -