Defining Brain Atrophy Subtypes in Parkinson's Disease with Distinct Therapeutic Effects of Deep Brain Stimulation

Motivation: Parkinson's disease (PD) patients in advanced stages harbor heterogeneous outcomes of deep brain stimulation (DBS) treatment. Goal(s): To develop pre-surgical imaging classification of PD patients to guide DBS therapy. Approach: The Subtype and Stage Inference model was used to identify distinct brain atrophy subtypes among PD patients by deviations from normative reference. Clinical variables and post-DBS motor outcomes across atrophy subtypes and stages were finally analyzed. Results: Three distinct spatiotemporal brain atrophy subtypes were identified in PD, with distinct clinical and prognostic features. Impact: The novel PD imaging subtypes can aid clinical decision-making regarding the optimal subtype and timing for DBS therapy.