Technical Feasibility of Quantitative Susceptibility Mapping Radiomics for Predicting Deep Brain Stimulation Outcomes in Parkinson’s Disease

Alexandra G Roberts, Jinwei Zhang, Ceren Tozlu, Dominick Romano, Sema Akkus, Heejong Kim, Mert R. Sabuncu, Pascal Spincemaille, Yi Wang, Brian H. Kopell

Abstract:

Parkinson’s disease (PD) patients with motor complications are
often considered for deep brain stimulation (DBS) surgery. Predicting symptom improvement to
separate DBS responders and non-responders remains an unmet need. Currently, DBS candidacy
is evaluated using the levodopa challenge test (LCT) to confirm dopamine responsiveness and
diagnosis. However, prediction of DBS success by measuring presurgical symptom improvement
associated with levodopa dosage changes is highly problematic. Quantitative susceptibility
mapping (QSM) is a recently developed MRI method that depicts brain iron distribution. As
the substantia nigra and subthalamic nuclei are well-visualized, QSM has been used in presurgical
planning of DBS. Spatial features resulting from iron distribution in these nuclei have been
previously linked with disease progression and motor symptom severity. Given its clear target
depiction and prior findings regarding susceptibility and PD, this study demonstrates the technical
feasibility of predicting DBS outcomes from presurgical QSM.