Analysis of diffusion changes in cerebral tissues in parkinson patients with subthalamic nucleus deep brain stimulation

Parkinson's disease (PD), with the decrease in the number and activity of dopaminergic neurons; it is a neurodegenerative disease in which cardinal symptoms such as tremor, rigidity and bradykinesia occur. In this study, we aimed to analyze possible appearant diffusion coefficient (ADC) changes in different areas of the brain in patients with Parkinson's disease in whom bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) surgery was performed before and in the third month of post-operative stimulation. Patients who underwent STN-DBS surgery for PD between 2017 and 2019 were included in this study. The results of diffusion magnetic resonance imaging (MRI), Unified Parkinson Disease Rating Scale (UPDRS) III scores, Beck and Hamilton depression tests were recorded before and at the 3rd month of postoperative stimulation. The comparison of the parametric data obtained was made using the Wilcoxon signed rank test. The results were within the 95% confidence interval and p <0.05 values were considered significant. Our study was conducted with a total of 13 patients, 8 men and 5 women. As a result of measurements made in a total of 32 different regions, especially in the motor and neuropsychiatric areas of the brain, an increase in ADC values was found in all areas. ADC changes of eight localizations such as left corpus callosum, right corona radiata, left corona radiata, hippocampus, right insula, left superior cerebellar peduncle, left caudate nucleus and left putamen were statistically significant. UPDRS III scores improved by 57% (p <0.05), and Beck and Hamilton depression scores by 25% and 33%, respectively (p> 0.05). Diffusion MRI is an inexpensive, fast, non-radiation, effective and safe imaging method for the evaluation of cerebral perfusion in Parkinson's patients undergoing deep brain stimulation. STN-DBS treatment contributes to the improvement of motor and neuropsychiatric symptoms by increasing blood flow in cerebral tissues in Parkinson's patients. Keywords: Apparent diffusion coefficient, deep brain stimulation, neuromodulation, Parkinson's disease, subthalamic nucleus.