Deep brain stimulation of the subthalamic nucleus (STN-DBS) effectively treats motor and non-motor symptoms in advanced Parkinson’s disease (PD). As considerable interindividual variability of outcomes exists, neuroimaging-based biomarkers, including microstructural metrics, have been proposed to anticipate treatment response. In this prospective open-label study, we sought to detect microstructural properties of brain areas associated with short-term non-motor outcomes following STN-DBS. Thirty-seven PD patients underwent diffusion MRI and clinical assessments at preoperative baseline and 6-month follow-up. Whole brain voxel-wise analysis assessed associations between microstructural metrics and non-motor outcomes. Intact microstructure within specific areas, including the right insular cortex, right putamen, right cingulum, and bilateral corticospinal tract were associated with greater postoperative improvement of non-motor symptom burden. Furthermore, microstructural properties of distinct brain regions were associated with postoperative changes in sleep, attention/memory, urinary symptoms, and apathy. In conclusion, diffusion MRI could support preoperative patient counselling by identifying patients with above- or below-average non-motor responses.

丘脑底核深部脑刺激 (STN-DBS) 可有效治疗晚期帕金森病 (PD) 的运动和非运动症状。由于结果存在相当大的个体差异，基于神经影像的生物标志物（包括微观结构指标）已被提议用来预测治疗反应。在这项前瞻性开放标签研究中，我们试图检测与 STN-DBS 后短期非运动结果相关的大脑区域的微观结构特性。 37 名 PD 患者在术前基线和 6 个月随访时接受了弥散 MRI 和临床评估。全脑体素分析评估了微观结构指标与非运动结果之间的关联。特定区域（包括右岛皮质、右壳核、右扣带回和双侧皮质脊髓束）内完整的微观结构与术后非运动症状负担的更大改善相关。此外，不同大脑区域的微观结构特性与术后睡眠、注意力/记忆、泌尿系统症状和冷漠的变化相关。总之，扩散 MRI 可以通过识别非运动反应高于或低于平均水平的患者来支持术前患者咨询。