Evidence map›Paper›PMID 41467597›Full record

ArticleMovement disorders : official journal of the Movement Disorder Society2026

Functional Connectivity to the Cerebellum and Resting-State Networks Predict Earlier Improvement of Dystonia Following Globus Pallidus Internus-Deep Brain Stimulation (GPi-DBS).

A Enrique Martinez-Nunez, Vyshak Chandra, Chance R Fleeting, Aashay Patel, Kelly D Foote, Justin D Hilliard, Marta San Luciano Palenzuela, Coralie de Hemptinne, Michael S Okun, Joshua K Wong

Abstract read
In one paragraph

Article in Movement disorders : official journal of the Movement Disorder Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Distinct Brain Drivers and Shared Cerebello-Cortical Input in ADCY5 and SGCE Hyperkinetic Movements.Movement disorders : official journal of the Movement Disorder Society · 2026
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

A Enrique Martinez-NunezNorman Fixel Institute for Neurological Diseases, Department of Neurology, University of Florida, Gainesville, Florida, USA.
Vyshak ChandraDepartment of Neurosurgery, University of Florida, Gainesville, Florida, USA.
Chance R FleetingCollege of Medicine, University of Florida, Gainesville, Florida, USA.
Aashay PatelCollege of Medicine, University of Florida, Gainesville, Florida, USA.
Kelly D FooteNorman Fixel Institute for Neurological Diseases, Department of Neurology, University of Florida, Gainesville, Florida, USA.
Justin D HilliardNorman Fixel Institute for Neurological Diseases, Department of Neurology, University of Florida, Gainesville, Florida, USA.
Marta San Luciano PalenzuelaMovement Disorders and Neuromodulation Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA.
Coralie de HemptinneNorman Fixel Institute for Neurological Diseases, Department of Neurology, University of Florida, Gainesville, Florida, USA.
Michael S OkunNorman Fixel Institute for Neurological Diseases, Department of Neurology, University of Florida, Gainesville, Florida, USA.
Joshua K WongNorman Fixel Institute for Neurological Diseases, Department of Neurology, University of Florida, Gainesville, Florida, USA.ORCID https://orcid.org/0000-0002-4632-3417

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDeep brain stimulation (DBS) of the globus pallidus internus (GPi) is an established treatment for dystonia. However, the time from device activation to clinical improvement is typically prolonged, variable, and unpredictable. While most patients improve gradually over months, some show significant benefit within weeks. The neuroanatomical and network-level mechanisms underlying early response remain unknown.

objectiveTo investigate the structural and functional correlates of earlier symptom improvement in patients with isolated dystonia who responded to bilateral GPi-DBS.

methodsThis retrospective study enrolled 46 patients. Early responders were defined as achieving ≥25% reduction in Unified Dystonia Rating Scale (UDRS) scores within 3 months post-surgery. Preoperative magnetic resonance imaging (MRI) and postoperative computed tomography data were processed to localize electrodes, model volume of activated tissue, and calculate electric fields. Functional connectivity was assessed using normative resting-state functional MRI (fMRI) data, while structural connectivity was estimated using fiber filtering of a histology-based atlas.

resultsA stimulation 'sweet spot' at the ventral border of the lateral GPi and medial globus pallidus externus (GPe) was associated with early improvement. Early response correlated with neuromodulation of GPe-subthalamic nucleus fibers and lenticular fasciculus. Stimulation sites connected to cerebellar cortex (lobules IX, crus I, crus II), default mode, and limbic networks were associated with earlier benefit.

conclusionsThese findings support a broader network model integrating cerebellum, limbic system, and basal ganglia in dystonia. Stimulation of cerebellar-connected circuits may accelerate improvement independent of classical somatomotor networks. Results highlight novel targets and mechanisms for improving DBS effectiveness, suggesting multitarget, network-informed strategies could enhance therapeutic outcomes. © 2025 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Indexed as

CerebellumDeep Brain StimulationDystoniaDystonic DisordersGlobus PallidusNerve NetAdultAgedFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedNeural PathwaysRetrospective StudiesTreatment Outcomeconnectomicsdeep brain stimulationdystoniaearly improvementresting state

Identifiers

PMID41467597
PMCPMC13022583

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.